Direct Anterior Versus Posterior Total Hip Arthroplasty Surgical Approaches
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis
- Sponsor
- New Lexington Clinic
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Time to discontinued use of an assistive ambulatory device (cane or walker)
- Last Updated
- 10 years ago
Overview
Brief Summary
Hip replacement is a common surgical procedure performed to relieve the pain and disability. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the hip with metal and plastic components shaped to allow continued motion of the hip. Surgeons may perform this operation in several different ways. The purpose of this study is to compare two different methods of performing total hip replacement. The investigators hypothesize that subjects treated with the anterior approached may show improved function during the early postoperative period, but that no differences in pain or function will be present after the first postoperative year.
In this study, patients that have elected to have hip replacement and consented to participate in the study will be randomized to have his or her hip replaced using one of two surgical techniques. Subjects will be randomized to be implanted using either an anterior or posterior approach. With the anterior approach, the study surgeon will use an incision that is on the front of the hip, and with the posterior approach, the incision will be more on the backside of your hip. The study surgeon has done more than 300 total hip replacements with both of these techniques.
A baseline assessment will be conducted before hip replacement surgery that includes x-rays, functional tasks like getting up from a chair and stepping down a step, and three questionnaires about the hip, the subject's general health, and how well the subject is able to function. Also, subjects will be required to return to the clinic at several time points after surgery for follow-up visits. Follow-up visits will include hip assessments and questionnaires, as well as follow-up hip x-rays. The follow-up visits will be 6 weeks, 3 months, 1 year, 2 years, 5 years, 7 years, and 10 years after hip replacement surgery. These follow-up visits are part of the study surgeon's normal routine for hip replacement patients, and are not extra visits as a part of this study.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Between ages of 18 and 85
- •End stage hip joint degeneration
- •Has elected to undergo primary total hip arthroplasty
Exclusion Criteria
- •Undergoing revision arthroplasty
- •Inflammatory or rheumatoid arthritis
- •Patients with confounding medical conditions that are not expected to survive for the duration of follow-up (10 years)
- •Body Mass Index greater than 40 kg/m2
- •Age \< 18 or \> than 85
- •Previous ipsilateral hip surgery including arthroscopic procedures
Outcomes
Primary Outcomes
Time to discontinued use of an assistive ambulatory device (cane or walker)
Time Frame: 6 week postoperative follow-up
Secondary Outcomes
- modified Harris Hip Score(Preoperative (no more than 3 months before surgery), and at 6-week, 12-week, 1-, 2-, 5-, 7-, and 10-year follow-ups)
- SF-12(Preoperative (no more than 3 months before surgery), and at 6-week, 12-week, 1-, 2-, 5-, 7-, and 10-year follow-ups)
- Lower Extremity Functional Score(Preoperative (no more than 3 months before surgery), and at 6-week, 12-week, 1-, 2-, 5-, 7-, and 10-year follow-ups)
- Functional force testing(Preoperative (no more than 3 months before surgery), and at 6-week, 12-week, 1-, 2-, 5-, 7-, and 10-year follow-ups)
- implant survivorship(1-, 2-, 5-, 7-, and 10-year follow-ups)
- Length of hospital stay(Collected during the hospital stay (usually 1 to 5 days))
- Operative time(Intra-operative)
- Number of patients that require blood transfusion(Intra-operative)