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The ACTIVE Trial: A Prospective Randomised Control Trial Of The H1 Implant Versus Total Hip Replacement

Not Applicable
Not yet recruiting
Conditions
Inflammatory Arthritis
Osteoarthritis, Hip
Interventions
Device: The H1 Implant
Device: Cementless total hip replacement
Registration Number
NCT06162195
Lead Sponsor
Embody Orthopaedic Limited
Brief Summary

The goal of this randomised controlled trial is to compare the success of two types of hip replacement in patients with hip arthritis. The main question it aims to answer is whether a new type of hip replacement (called a hip resurfacing) can be as successful as an existing hip replacement (called a total hip replacement). Patients will be given either the new hip resurfacing or the existing total hip replacement and researchers will compare their function, complication rate and physical activity.

Detailed Description

The H1 Implant is a cementless, ceramic hip resurfacing arthroplasty (HRA) device. The intended purpose of the H1 Implant is to provide an artificial substitute for a disease-damaged hip joint to replace the articulating surfaces of the hip while preserving the underlying femoral head and natural femoral neck. This is standard for a resurfacing hip prosthesis. This study will randomise patients to receive either The H1 Implant or a primary cementless ceramic-on-poly or ceramic-on-ceramic total hip replacement (THR). Composite clinical success (CCS) scores, physical activity levels and patient reported outcome measures (PROMs) will be compared for the two groups. The primary objective of the study is to determine whether the H1 Implant is non-inferior to cementless THR in terms of CCS. The key secondary objective is to determine whether the H1 Implant is superior compared to cementless THR in terms of physical activity and PROMs. Other secondary objectives are to compare the H1 Implant and THR with respect to: safety, through collection of all device-related, operative site-related and systemic adverse events; and noise generation, through patient survey.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Patient requires unilateral primary hip arthroplasty due to primary osteoarthritis, osteoarthritis secondary to e.g. trauma, avascular necrosis or developmental hip dysplasia, or inflammatory arthritis.
  • Patient is willing to comply with study requirements.
  • Patient plans to be available through 10 years postoperative follow-up.
Exclusion Criteria
  • Patient has a BMI greater than 40 kg/m².
  • Patient has active infection or sepsis (treated or untreated).
  • Patient has insufficient bone stock at the hip (>1/3 necrosis of the femoral head or large and multiple cysts) or in general as in severe osteopenia or osteoporosis (t-score < -2.5 as measured with BMD).
  • Patient is not skeletally mature.
  • Patient meets the contraindication criteria of the control device.
  • Patient already has another lower limb arthroplasty or arthrodesis or will require a further lower limb arthroplasty or arthrodesis within the subsequent 2 years.
  • Patient lacks capacity to consent.
  • Patient is unable to understand the native language of the country where their procedure is taking place

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
The H1 ImplantThe H1 ImplantCementless, ceramic-on-ceramic hip resurfacing arthroplasty (HRA) device.
Cementless total hip replacementCementless total hip replacementCementless ceramic-on-poly or ceramic-on-ceramic total hip replacement
Primary Outcome Measures
NameTimeMethod
Composite clinical success (CCS)24 months post-operatively

The primary outcome is "composite clinical success". This is a binary outcome measure. Patients are deemed to have achieved CCS if they meet all of the following criteria at the 24 month timepoint:

* Modified Harris Hip Score ≥80.

* No revision or pending revision.

* Acetabular radiolucencies: not in all zones.

* Femoral radiolucencies: not in all zones.

* Absence of subsidence/migration of the acetabular or femoral component \>5mm with clinical findings.

* Absence of specific adverse device effects (ADEs) that are pre-cursors to revision of the device, namely:

* Bone breakage around the implanted component(s) (periprosthetic fracture).

* Breakage of the device component.

* Device movement/migration of clinical consequence as defined by associated clinical findings as: a limp; leg length discrepancy; and restricted range of motion.

* Dislocation of the hip joint.

Secondary Outcome Measures
NameTimeMethod
Physical ActivityPre-operatively, 6 months, 12 months and 24 months post-operatively

UCLA (University of California Los Angeles) Activity Score

Noise6 weeks, 6 months, 12 months and 24 months post-operatively

Noise questionnaire

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