Minimal Invasive Surgery in Total Hip Arthroplasty Patients; Strength, Functionality and Post Operative Complications
Condition: Hip Osteoarthritis
MeSH terms: Osteoarthritis, Hip; Postoperative Complications
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Direct lateral; minimal invasive; modified minimal invasive
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Total hip replacement; direct lateral approach; Total hip replacement; minimal invasive approach; Total hip replacement; modified minimal invasive approach
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Arthroplasty, Total Hip Replacement, Hip; Surgical Procedures, Operative; Surgical Procedures, Minimally Invasive