Hip Osteoarthritis Clinical Trial
Official title:
Minimal Invasive Surgery in Total Hip Arthroplasty Patients; Short- and Long Term Results
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 the direct lateral approach
(DLA), the posterior approach (PA) and the anterior approach (AA). The latter is a modified
Smith-Petersen approach which follows the principles of minimally invasive surgery (MIS).
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 the AA than the PA and
the DLA. Patients in the AA group are also thought to 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.
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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