Hip Arthropathy Clinical Trial
Official title:
Kinematic vs Mechanical Alignment Technique for Primary Total Hip Replacement in Patient With Hip Arthritis: a Prospective Comparative Non Randomised Study
Background
- In the 19th century, Sir John Charnley successfully introduced total joint replacements
for hips. In order to prevent implant fixation failure and accelerated polyethylene
wear, it was initially recommended that implants were systematically positioned in a
"biomechanically-friendly" way, which disregarded most of the individual anatomy
(medialized acetabular cup, systematized cup version and inclination, etc.)
- While those initial surgical techniques made popular and clinically successful total
joint replacements, many complications (aseptic loosening, pain, excessive wear) have
remained and mainly the persistence of frequent instability after THA. In response to
those complications, many improvements were developed in the area of joint replacement
over the last few decades, with one the most recent dating from 2017 and being the
development of a surgical technique Rationale
- The kinematic alignment (KA) technique for total hip arthroplasty (THA) aims at
restoring the acetabular center of rotation and as much as possible the constitutional
acetabular anteversion by using the transverse acetabular ligament (TAL) as a reference
landmark. Also, the technique aims (1) at making personalized choice for the hip
component design, (2) at defining the cup positioning, and (3) at sometimes considering
additional spine surgery based on the assessment of the individual spine-hip relation.
- KA techniques for hip replacements are relatively new, likely to become popular over
time, and their true value remains to be determined.
- Objective: Evaluation of the kinematic alignment technique for hip prostheses in patient
with hip osteoarthritis
- Hypothesis: the consideration of hip pathoanatomy and lumbo-pelvic kinematic disorder
when planning a hip replacement is likely to decrease the risk of prosthetic dislocation
and improve patient function and satisfaction
;
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