Comparative Study of Minimally Invasive Surgical Approaches for Total Hip Arthroplasty

National and Kapodistrian University of Athens

Status: Unknown

Conditions: Anterior Approach; Hip Arthropathy; Hip Osteoarthritis; Tissue Injury; Minimal Invasive

Treatments: Procedure: Mini posterior approach Total Hip Replacement; Procedure: Anterior approach total hip replacement without a traction table; Procedure: Anterior approach total hip replacement with a traction table

Study type: Interventional

Funder types: Other

Identifiers

NCT04311125

4

Details and patient eligibility

About

Total hip arthroplasty is a method of choice for treating advanced osteoarthritis of the hip and one of the most frequent orthopedic procedures. Of all hip surgical approaches described, the tendency for minimally invasive techniques has been dominated over the last few years due to faster patient mobilization, reduced postoperative pain and need for blood transfusion. Two of the most common approaches used for minimally invasive total hip arthroplasty are: AMIS anterior approach and mini-posterior approach, which is a modification of the standard posterior approach. The purpose of this study is the biochemical, imaging and clinical evaluation of the tissue damage caused by the above-mentioned techniques of minimally invasive total hip arthroplasty.

Enrollment: 90 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients that sign the Informed consent
• Patients aged 18 years and over who are going to undergo primary total hip arthroplasty

Exclusion criteria

I. Active infection II. Previous hip operation in any leg III. Any kind of operation the past 3 months IV. Obesity (BMI, Body Mass Index >30) V. Autoimmune diseases or myositis of any etiology VI. Active cancer

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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90 participants in 3 patient groups

total hip arthroplasty via the mini posterior approach

Active Comparator group

Description:

total hip arthroplasty via the mini posterior approach. This approach was first described by Kocher and Langenbeck and later modified by Gibson in 1950. There is a convex incision centered on the posterior rim of the major trochanter. The incision follows the curve of the buttock and at the height of the posterior lip of the major trochanter, it is peripherally oriented along the posterior outer surface of the femur. The major gluteus is divided along the muscle fibers. Guiding sutures are inserted into the tendon mass of the hip rotor muscles just prior to their origin on the major trochanter and dissected to expose and subsequently retract the posterior hip capsule.

Treatment:

Procedure: Mini posterior approach Total Hip Replacement

THR via the anterior approach without traction table

Active Comparator group

Description:

The anterior approach is a modification of the classic Smith- Peterson anterior hip approach as described by Berend et al in 2009 \[7\]. This approach utilizes the intermuscular plane between the tendon fascia lata and the sartorius muscle, and laterally repairs the fibers of the rectus femur to expose and enclose the anterior pubic joint. A surgical traction table may be used during surgery.

Treatment:

Procedure: Anterior approach total hip replacement without a traction table

THR via the anterior approach with a traction table

Active Comparator group

Description:

The anterior approach is a modification of the classic Smith- Peterson anterior hip approach as described by Berend et al in 2009 \[7\]. This approach utilizes the intermuscular plane between the tendon fascia lata and the sartorius muscle, and laterally repairs the fibers of the rectus femur to expose and enclose the anterior pubic joint. A surgical traction table may be used during surgery.

Treatment:

Procedure: Anterior approach total hip replacement with a traction table