Minimal Invasive Surgery in Total Hip Arthroplasty Patients; Short- and Long Term Results
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Muscle strength
研究概览
简要总结
The aim of the present study is to explore the most efficient surgical approach in total hip replacement in short and long term when concerning strength, functionality and postoperative complications.
The objective is to register muscular strength, hip joint functionality/mobilisation and complications after total hip arthroplasty (THA) performed by the direct lateral approach (DLA), the posterior approach (PA) and the anterior approach (AA). The latter is a modified Smith-Petersen approach which follows the principles of minimally invasive surgery (MIS).
The primary working hypothesis is that due to a minimal dissection and reduced trauma in the muscles, patients will tolerate early hospital discharge better after the AA than the PA and the DLA. Patients in the AA group are also thought to be more active and maintain muscular strength and hip joint functionality/mobilisation better than patients in the lateral group.
详细描述
With total hip replacement surgery, the orthopaedic surgeon's aim is not only pain relief for the patient, but also restoration of hip joint biomechanics resulting in a minimal functional deficit and maximal longevity of the implant. It is not exceptional that these patients still experience mild to moderate long-term impairments postoperatively. These impairments include pain, muscle weakness of the hip abductors, contracture of the hip, gait disorders, as well as weakness of hip extensors and flexors. These problems may in turn lead to complications such as joint instability and loosening of the implant.
MIS is defined as a surgical approach performed through a short skin and muscle incision to avoid injury to muscles and tendons. Following minimally invasive approach reduced muscle trauma has been found. Moreover clinical outcome improved, as the gluteus medius muscle can be spared more successfully. However, it is debated whether or not the overall results of MIS are superior, or even as good as the traditional hip replacement surgery in terms of component placing and time to revision of the prosthesis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- — 至 70 Years(Child, Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients scheduled for THA
- •Diagnosis of primary osteoarthritis as the main cause for elective THA
- •American Society of Anesthesiologists (ASA) score I, II, and stable III
排除标准
- •Musculoskeletal diseases
- •Current heart/pulmonary- or malignant diseases likely to influence the physical testing performance.
研究组 & 干预措施
THA Direct lateral
Total hip arthroplasty (THA) carried out by direct lateral approach (DLA)
干预措施: Total hip arthroplasty direct lateral approach (Procedure)
THA Posterior
Total hip arthroplasty (THA) carried out by posterior approach (DLA)
干预措施: Total hip arthroplasty posterior approach (Procedure)
THA Anterior
Total hip arthroplasty (THA) carried out by anterior approach (DLA)
干预措施: Total hip arthroplasty, anterior approach (Procedure)
结局指标
主要结局
Muscle strength
时间窗: 3 months postoperatively
Measured by 1 repetition maximum (1 RM)
次要结局
- Hip joint functionality and mobility(3 months postoperatively)
- activity level(6 subsequent days postoperatively)
