Trochanteric Bursal Repair After a Total Hip Replacement - Are There Benefits During the First 90 Days
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 104
- 试验地点
- 2
- 主要终点
- Rate of posterior gluteal pain
研究概览
简要总结
During total hip arthroplasty surgery, the trochanteric bursa is routinely excised. This anatomical structure, which functions as a soft tissue barrier, is generally recommended for removal as it facilitates the surgical approach. However, recent studies have suggested that the trochanteric bursa is an important soft tissue barrier and may protect against infections. The aim of this study is to evaluate the differences in infection rates, wound complications, deep gluteal syndrome presence, pain, and clinical scores within the first 90 days between patients in whom the trochanteric bursa was repaired and those in whom it was not, and to provide recommendations regarding bursal repair.
详细描述
During total hip arthroplasty surgery, the trochanteric bursa is routinely excised. This anatomical structure, which functions as a soft tissue barrier, is typically recommended for removal as it facilitates the surgical approach. However, recent studies have suggested that the trochanteric bursa is an important soft tissue barrier and may provide protection against infections. The aim of this study is to evaluate the differences in infection rates, wound complications, deep gluteal syndrome presence, pain, and clinical scores within the first 90 days between patients in whom the trochanteric bursa was repaired and those in whom it was not, and to provide recommendations regarding bursal repair.
This research will be a prospective randomized controlled trial with patients subjected to sequential randomization. One group of patients will undergo the routine excision of the bursa during surgery, referred to as Group 1. In the other group, the trochanteric bursa will be carefully retracted and subsequently repaired in its anatomical location beneath the fascia after the surgical procedure. Wound closure will be performed routinely, with subcutaneous and skin closure. All patients will have a Hemovac drain placed, and they will follow the same rehabilitation protocol.
Patients will be evaluated on postoperative days15, 30, and 90 using Visual Analog Scale scores, and on days 30 and 90 using the Harris Hip Score. Additionally, patients will be assessed for tenderness on palpation, the presence of hip snapping (a sensation of the hip catching), hemoglobin drop, 90-day infection rates, and the presence of deep gluteal syndrome.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients between 18 to 90 years of age
- •With a diagnosis of primary hip osteoarthritis
- •Willing to be included in the study
排除标准
- •Patients who had a known history of trochanteric bursitis, deep gluteal syndrome, sciatica, vertebral fracture, hip fracture, hip arthroscopy, and core decompression surgery
- •Patients who had a history of bursal injection within 6 months
- •Patients undergoing hip arthroplasty with a shortening osteotomy
结局指标
主要结局
Rate of posterior gluteal pain
时间窗: First postoperative 90 days
The condition is also refered to as Deep Gluteal Syndrome - Recorded as Yes / No
Rate of superficial wound problems
时间窗: First postoperative 90 days
Wound leakage, superficial infection, wound dehiscence - Recorded as Yes / No
Rate of painful trochanteric bursitis
时间窗: First postoperative 90 days
Recorded as pain on the trochanteric region on palpation - Recorded as Yes / No
次要结局
- Range of motion (ROM)(First postoperative 90 days)
- Visual Analog Scale (VAS)(First postoperative 90 days)
- Harris Hip Score (HHS)(First postoperative 90 days)
研究者
Enejd Veizi, MD
Assistant Professor
Ankara City Hospital Bilkent