Hip Osteoarthritis Clinical Trial
Official title:
Minimal Invasive Surgery in Total Hip Arthroplasty Patients; Strength, Functionality and Post Operative Complications
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 two minimal invasive/incision
surgeries (MIS) versus the traditionally lateral approach.
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 MIS than after
traditional lateral surgery. Patients in the MIS group will also be more active and maintain
muscular strength and hip joint functionality/mobilisation better than patients in the
lateral group.
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. When the lateral surgical approach is
used, major concerns after total hip replacement surgery are muscle abductor
weakness/atrophy, tendon defects of the gluteus minimus muscle, and unsuccessful reattachment
or denervation of the anterior gluteal flap.
Minimal incision/invasive surgery (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.
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