Tissue Sparing Surgery in Total Hip Arthroplasty
Condition: Total Hip Arthroplasty; Hip Arthrosis
MeSH terms: Osteoarthritis; Osteoarthritis, Hip
Study type: Interventional

Summary: 
      Rationale of the study is to evaluate through a prospective randomized controlled study if a
      modified direct superior posterolateral approach (sperimental approach) to the hip
      articulation which entirely spares i.e. avoids the sacrifice of the fascia lata might elicit
      a better outcome in terms of gait, balance, strengths recovery, clinical performance, patient
      reported outcome measurement (Short Form-12(SF-12); Hip disability and Osteoarthritis Outcome
      Score (HOOS)) and overall recovery time in patients undergoing TotalHipArthroplasty with the
      aid of dedicated, modified instrumentation in order to properly access this modified route.

      The investigators expect an improvement on selected gait analysis parameters in sperimental
      approach in order of 2% of range of motion (ROM) recorded 1 month after surgery. Based on
      this assumption sample size calculation will be conducted.
    

Detailed description: 
      Rationale of the study is to evaluate through a prospective randomized controlled study if a
      modified direct superior approach (experimental approach) to the hip articulation which
      entirely spares i.e. avoids the sacrifice of the fascia lata (posterolateral approach) might
      elicit a better outcome in terms of gait, balance,strenghts recovery, clinical performance,
      patient reported outcome measurements and overall recovery time in patients undergoing
      TotalHipArthroplasty with the aid of dedicated, modified instrumentation in order to properly
      access this modified route.Two patients groups will randomly be allocated in one of the two
      group with a computer generated 1:1 randomization table.Total number of subjects
      participating in the study:50.
    

Intervention name(s): Direct Superior Approach; posterolateral approach
Intervention type(s): Procedure; Procedure
Intervention description(s): GROUP II :Patients positioned in lateral decubitus.landmark for incision is the apex of the greater trochanter,and skin, subcutaneous tissue except fascia are incised accordingly. Fibers of gluteus will be separated and not incised.posterior capsulotomy is performed,;femur is dislocated and neck osteotomy carried out, followed by preparation of femoral canal with progressive broach. Acetabulum is prepared with burs of increasing diameter, and acetabular cup is impacted. A polyethylene insert and a femoral rasp are subsequently introduced.All remaining definitive implants can be positioned.; GROUP I:patients are positioned in lateral decubitus.Landmark for incision is the apex of the greater trochanter.posterior capsulotomy is performed, femur is dislocated and neck osteotomy carried out, followed by preparation of femoral canal with progressive broach.Acetabulum is prepared with burs of increasing diameter,and acetabular cup is then impacted.All definitive implants can be positioned.
Other intervention name(s): DSA
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: tissue sparing surgery