Osteoarthritis, Hip Clinical Trial
Official title:
Change of Cognitive Performance for Older People Through Artificial Hip Replacement Implantation [German Title: Veränderungen Der Kognitiven Leistungsfähigkeit älterer Menschen Durch Hüft-TEP Implantation]
The purpose of this study is to investigate the effectiveness of a hip arthroplasty for chronic pain, caused by a unilateral primary Coxartrhrose, regarding the cognitive performance. It is based on the hypothesis that the combination of chronic pain along with relative immobilization causes impairment of cognitive performance. The total hip replacement reduces pain, increases the mobility level and finally improves the cognitive performance.
Studies have shown that cognitive performance, especially in the elderly is limited due to
chronic pain. In a recent study, significantly less brain activity in various regions of the
brain (the anterior cingulate cortex (ACC), insula and operculum, dorsolateral prefrontal
cortex and orbitofrontal cortex) was detected in patients with unilateral primary
coxarthrosis compared to a healthy control group. After eliminating the pain by the
implantation of a total hip replacement, a significant increase in brain activity in the
affected areas was observed in these patients. Whether this observation is accompanied by an
effect on cognition, is not known and will be investigated in the proposed study. The purpose
of this study is to investigate the effectiveness of a hip arthroplasty for chronic pain,
caused by a unilateral primary Coxartrhrose, regarding the cognitive performance. It is based
on the hypothesis that the combination of chronic pain along with relative immobilization
causes impairment of cognitive performance. The total hip replacement reduces pain, increases
the mobility level and finally improves the cognitive performance.
The main issue concerns the short and mid-term influence of hip replacement on cognitive
performance in the perioperative care continuum in comparison to a control group that does
not have chronic pain. To objectively quantify the everyday activity, there are a variety of
instruments, without a currently gold standard. Therefore, in addition the investigators use
objectified measurement parameters with the aid of a pedometer (GARMIN vivofit) on every
three measuring time points (before surgery, 3 months after surgery, 6 months after surgery).
Standardized neuropsychological assessment methods are used to assess the cognitive
performance. To assess the degree of mobility, health status and the physical activity
standardized questionnaires are used.
Primary hypothesis: After implantation of an artificial hip replacement and reduction of
experienced pain patients with primary coxarthrosis indicate an improvement of cognitive
performance 3 and 6 month after surgery compared to the pre-surgical status. In addition, the
investigators measure how severe the cognitive performance is reduced compared to a healthy
control group prior to surgery and to what extend the cognitive performance is reversible in
the aftermath.
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