Clinical Improvement Obtained by Endoscopic Ilio-Psoas Tenotomy (Lesser Trochanter Versus Acetabular Notch)

Study Overview
=================
Brief Summary
-----------------
The purpose of the study is to assess Oxford Hip Score at baseline, at 2 months and at over 12 months.

Detailed Description
-----------------
This is an interventional, comparative, randomized study, in 2 parallel groups, single-blind (the patient does not know which technique he will benefit from, the surgeon will carry out the surgery and will therefore be informed of the result of the randomization ) and monocentric. Comparative prospective cohort study of an endoscopic tenotomy surgery of the iliopsoas tendon at the level of the lesser trochanter versus at the level of the acetabular notch, in the context of anterior pain for impingement between the iliopsoas tendon and the prosthetic cup in patients after Total Hip Prosthesis. The study will be proposed to the patient during the preoperative consultation. Patients eligible for surgery will be offered the study. After a reflection period of at least 15 days, patients who agree to participate in the study will be included. Randomization will be done by drawing lots to decide whether the endoscopic tenotomy will be performed at the level of the lesser trochanter or at the level of the acetabular notch. The surgery will be performed under general anesthesia with standardized multimodal analgesia. Whatever the techniques, the approaches, the instruments to perform the procedure and the postoperative course will be identical, as in usual practice.

Official Title
-----------------
Study Evaluating the Clinical Improvement Obtained by Endoscopic Tenotomy of the Ilio-Psoas, at the Level of the Lesser Trochanter Versus at the Level of the Acetabular Notch, on Psoas Cup Impingements After Total Hip Prosthesis

Conditions
-----------------
Tendinopathy

Intervention / Treatment
-----------------
* Procedure: Endoscopic tenotomy surgery of the iliopsoas tendon


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age ≥ 18 years old; Definite diagnosis of iliopsoas tendinopathy due to conflict between the tendon and the prosthetic cup; Failure of first-line conservative treatment; Planned endoscopic tenotomy; Affiliation to the social security scheme; Signed informed consent. Exclusion Criteria: Revision total hip prosthesis, multiple operations prior to tenotomy; Other surgical or medical interventions planned during the study; Participation in another clinical trial, or during a period of exclusion from another clinical trial; Pregnant or likely to be pregnant (of childbearing age, without effective contraception) or breastfeeding; Patient deprived of liberty or under guardianship or curatorship or unable to give consent.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Interventional, comparative, randomized study, in 2 parallel groups, single-blind
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Endoscopic tenotomy at the level of the lesser trochanter<br>Patients will benefit from endoscopic tenotomy surgery of the iliopsoas tendon at the level of the lesser trochanter. | Procedure: Endoscopic tenotomy surgery of the iliopsoas tendon<br>* The surgery will be performed under general anesthesia with standardized multimodal analgesia. Whatever the techniques, the approaches, the instruments to perform the procedure and the postoperative course will be identical, as in usual practice.<br>|
| Experimental: Endoscopic tenotomy at the level of the acetabular notch<br>Patients will benefit from endoscopic tenotomy surgery of the iliopsoas tendon at the level of the acetabular notch. | Procedure: Endoscopic tenotomy surgery of the iliopsoas tendon<br>* The surgery will be performed under general anesthesia with standardized multimodal analgesia. Whatever the techniques, the approaches, the instruments to perform the procedure and the postoperative course will be identical, as in usual practice.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oxford Hip Score | Compare the clinical improvement experienced by patients having an endoscopic tenotomy of the iliopsoas tendon at the level of the lesser trochanter versus at the level of the notch at more than 1 year minimum. The Oxford Hip Score is a self-administered patient-administered 12-item Patient Reported Outcome Measures questionnaire that allows the surgeon to assess clinical outcomes after total hip replacement. | 1 year |