Arthropathy of Hip Clinical Trial
Official title:
An Investigation of the Relationship Between Total Hip Implant Position and Hip Range of Movement
The aim of the study is to determine the influence of the combined anteversion of acetabular cup and the femoral stem used in total hip arthroplasty on the theoretical and actual range of motion of the hip in three dimensional space.
Ninety patients from the clinics of a single consultant orthopaedic surgeon, who are listed
to for total hip arthroplasty will be recruited to the study. They will have their surgery
performed by the participating consultant as per his standard practice for the target study
patient. This involves using the Excia T cementless stem, the ceramic femoral head, the
Plasmafit Plus cementless liner and the Biolox delta acetabular cup all by B Braun Medical
Ltd. The participating consultant routinely uses computer aided orthopaedic surgery (CAOS)
techniques to implant the stem and the acetabular cup and all study patients will have
surgery using these techniques.
Participants will have their standard in-patient care and rehabilitation. Standard hospital
practice for hip arthroplasty patients is for them to return to the hospital for a
post-operative review at three months. During this appointment they will be reviewed by a
member of the arthroplasty team and have two radiographs taken, an anterior/posterior view of
the full pelvis and a lateral view of the index hip. Study participants will return for the
three month post-operative review and be seen by the arthroplasty team as standard, but will
not have the two radiographs taken. Instead, they will have a computed tomography (CT) scan
taken of the full pelvis. In addition to the standard clinical outcome data collected,
Participants will also complete the Harris Hip Score and a range of motion questionnaire.
Study participants will also have an additional assessment as part of their three month
post-operative review. In the movement analysis laboratory in the Golden Jubilee National
Hospital, they will undergo a RoM assessment using clinical movement analysis techniques.
During this assessment, participants will be asked to fully flex/extend their hip joint,
fully abduct/adduct it, fully internally/externally rotate it and finally fully circumduct
it. While performing these tasks, their hip joint movement will be tracked by a number of
infrared cameras identifying small reflective markers attached to their body. A computer can
convert these data into three dimensional RoM data for further analysis. At the end of their
three month post-operative review, the participant's involvement in the study will be
complete.
The computer used for CAOS is capable of measuring the on-table range of motion (RoM) of the
hip. This data will be collected for the purposes of the study. Mathematical methods will be
used to determine the theoretical RoM of the hip from the CT scan. The data from the movement
analysis session will give the actual RoM. The CT scan will be analysed to determine the
inclination and version of the acetabular cup and the torsion of the femoral stem. From this,
the combined anteversion (CA) of the cup/stem system will be determined. Comparison will be
made between the CA and the actual RoM to determine to what extent, if any, the CA influences
the RoM. Comparisons will be made between the on-table RoM and the theoretical RoM, and the
actual RoM to assess the accuracy of the methods used to determine the on-table and
theoretical RoMs.
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