A Comparative Study of In-vivo Wear Between 28 mm and 40 mm Metal Heads

Not Applicable

Terminated

Conditions: Arthroplasty, Replacement, Hip

Interventions: Device: Trident cup, X3 inserts, 28 mm head
Device: Trident cup, X3 inserts, 40 mm head
Device: Symax stem
Device: Accolade TMZF stem

Registration Number: NCT02525627

Lead Sponsor: Stryker Orthopaedics

Brief Summary: Prospective, single centre, randomized clinical study; series of patients with a 5-years patient evaluation period.

Detailed Description: This is a single centre randomized clinical outcomes study. The Symax stem or Accolade TMZF (Titan, Molybdenum, Zirconium, Ferrum) in combination with the Hemispherical Trident cup, X3 inserts, 28 and 40 mm Metal heads are the primary components to be implanted for evaluation.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 40

Inclusion Criteria

Male and non pregnant female patients between 18-75 years of age.
Patients requiring uncemented primary total hip arthroplasty (THA), suitable for the use of the Symax stem
Patients with a diagnosis of osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis (AVN) or post-traumatic arthritis (TA).
Patients who understand the conditions of the study and are willing and able to comply with the post-operative scheduled clinical and radiographic evaluations and the prescribed rehabilitation
Patients who signed the specific Informed Consent Form prior to surgery

Exclusion Criteria

Patients who require revision of a previously implanted THA
Patients who had a THA on contra-lateral side within the last 1 year.
Patients who had a THA on contralateral side more than 1 year ago and the rehabilitation period outcome was considered unsatisfactory or not good. (Patients with contra-lateral THA > 1 year ago with good outcome (Harris Hip Score > 85) can be included in the study).
Patients who will need lower limb joint replacement for another joint within one year.
Bilaterally operated patient.
Patients who have had a prior procedure of acetabular osteotomy.
Patients with active or suspected infection.
Patients with malignancy - active malignancy
Patients with a diagnosed systemic disease that would affect the subject's welfare or overall outcome of the study (i.e. severe osteoporosis, Paget's disease, renal osteodystrophy) or is immunologically suppressed, or receiving steroids in excess of physiologic dose requirements.
The patient has a neuromuscular or neurosensory deficit which would limit the ability to assess the performance of the device or the patient has a neurological deficit which interferes with the patient's ability to limit weight bearing or places an extreme load on the implant during the healing period.
Female patients planning a pregnancy during the course of the study.
Patients with systemic or metabolic disorders leading to progressive bone deterioration.
Patients, who as judged by the surgeon, are mentally incompetent or are unlikely to be compliant with the prescribed post-operative routine and follow-up evaluation schedule.
Patients with other severe concurrent joint involvements which can affect their outcome.
Patients with other concurrent illnesses which are likely to affect their outcome such as sickle cell anaemia, systemic lupus erythematosus, psoriasis, Insulin dependent Type I diabetes or renal disease requiring dialysis.
Surgeries to be performed with navigation and/or robot-assisted instruments.
Patient with a known sensitivity to device materials.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Trident cup, X3 inserts, 28 mm head	Symax stem	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.
Trident cup, X3 inserts, 28 mm head	Accolade TMZF stem	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.
Trident cup, X3 inserts, 28 mm head	Trident cup, X3 inserts, 28 mm head	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.
Trident cup, X3 inserts, 40 mm head	Trident cup, X3 inserts, 40 mm head	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.
Trident cup, X3 inserts, 40 mm head	Symax stem	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.
Trident cup, X3 inserts, 40 mm head	Accolade TMZF stem	Equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes. Trident cup in combination with Symax stem or Accolade TMZF stem.

Primary Outcome Measures

Name	Time	Method
To Compare Wear of the Polyethylene X3 Insert Based on Digital Radiographs Using the Hip Analysis Suite (HAS).	5 years follow-up	Determine equality of 5 year wear in the 28mm and the 40mm metal femoral head sizes using HAS, a software for the determination of polyethylene wear on digital radiographs.

Secondary Outcome Measures

Name	Time	Method
Merle D'Aubergine Score (MdA)	6 weeks, 3 months, 1, 2 and 5 years	The Merle D'Aubergine-Charnley Score is a simplified clinical scoring system for the hip. The overall score is determined by the sum of scores obtained from each dimension of pain, walking ability and joint mobility. The overall numeric score is given by adding the domain scores. Clinical grades: Excellent, 18, Good 15-17, Fair 13-14, Poor \<13.
Harris Hip Score (HHS) Patient Questionnaire	6 weeks, 3 months, 1, 2 and 5 years	Scores can range from 0 to 100 with 0 being the worst and 100 being the best score. A score of 80-100 is considered good-excellent and a score of less than or equal to 79 is considered fair-poor. 90-100 = excellent 80-89 = good 70-79 = fair 0-69 = poor.