Efficacy of Postoperative Pain Control Between Transarticular VS Periartiucular Multimodal Drug Infiltration in Total Hip Arthroplasty: Double-blinded Randomized Control Trial

Study Overview
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Brief Summary
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This research aim to improve postoperative outcome in total hip arthroplasty(THA) by using local mixture infiltration as bupivacaine + NSAID + epinephrine + tranxemic acid. In the present time these mixture components has shown to improve THA outcome by aspect of postoperative pain control, postoperative opioid consumption, postoperative bleeding, LOS and postoperative rehabilitation without increasing complication but the accuracy of infiltration technique which gives the best outcome has not been yet discovered.Recently study by Hashimoto et al has risen that these technique can be administrated by both periarticular and intra-articular approach.By considering the complexity of human anatomy around the hip tissue we assume that the intra-articular(transarticular) may given equivalence (may be better) outcome with lowering procedural related complication comparing to periarticular infiltration approach.

Official Title
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Efficacy of Postoperative Pain Control Between Transarticular VS Periartiucular Multimodal Drug Infiltration in Total Hip Arthroplasty: Double-blinded Randomized Control Trial

Conditions
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Pain, Post Operative, Arthroplasty Complications

Intervention / Treatment
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* Procedure: transarticular multimodal drug infiltration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient who would go on cemented and cementless THA age 45-60 years of age voluntary decision exclusion criteria bilateral THA revision surgery history of pelvic and hip surgery previously allergy to medication in protocol CKD stage 4-5, chronic liver disease with Child Pugh B or C pregnancy history of hip injection U/D hypercoagulable state abnormal laboratory coagulation study as INR > 1.4 or aPTT > 1.4 abnormal platelet function thrombocytopenia PE , DVT, ischemic stroke, CAD/ischemic heart disease use of anticoagulant or hormonal usage anesthesia by general anesthesia or additional nerve block can not understand PCA usage use postopertive wound drainage

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: transarticular multimodal drug infiltration<br>infiltration the mixture into intraarticular by catheter guided approach | Procedure: transarticular multimodal drug infiltration<br>* as described previously<br>|
| Active Comparator: periarticular multimodal drug infiltration<br>3 location of infiltration hip capsule gluteus medius and short external rotator gluteus maximus | Procedure: transarticular multimodal drug infiltration<br>* as described previously<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale at rest on postoperative day1st and 2nd |  | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total morphine consumption in first 24 hours postoperative period via PCA pump |  | 1 week | 
| total morphine consumption in whole postoperative period |  | 1 week | 
| length of stay |  | 1 week | 
| postoperative complication |  | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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total hip arthroplasty, transarticular multimodal drug infiltration, periarticular multimodal drug infiltration