Clinical trial NCT06711042: How Spinopelvic Movements Affect Hip Function After Total Hip Arthroplasty
Official title: The Effect of Spinopelvic Movements on Hip Functions in Patients With Total Hip Arthroplasty
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Total Hip Replacement
Hip Dislocation
Hip Osteoarthritis
Lead sponsor: T.C. ORDU ÜNİVERSİTESİ
Sponsor class: OTHER
First posted: 2024-12-02
Enrollment: 60
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study will include patients who underwent primary total hip arthroplasty using the posterolateral approach by the same surgeon at Ordu University Training and Research Hospital, Department of Orthopedics and Traumatology, during the years 2022-2023. Eligible patients must be aged 60 years or older and have a minimum of 12 months post-surgery.

Exclusion criteria include patients with modular neck implants, metal-metal, or ceramic bearing surfaces, hip infections, advanced osteoarthritis in the contralateral hip, leg length discrepancy, neurological, orthopedic, or systemic diseases affecting gait or balance, or a body mass index (BMI) greater than 40 kg/m².

Brief summary: Our study aims to evaluate the effect of spinopelvic movement on hip functions in individuals who have undergone total hip arthroplasty (THA). This study will contribute to the literature by helping identify and prevent issues experienced by THA patients, ranging from hip pain to limited mobility and even hip dislocation.

Detailed description: Total hip arthroplasty (THA) is a widely accepted surgical procedure that effectively alleviates pain, enhances mobility, and improves physical function in patients with hip osteoarthritis. However, improper placement of implants during surgery can lead to complications such as abnormal edge loading, early wear of polyethylene components, ceramic insert fractures, or hip dislocations, often requiring early revision surgeries. While Lewinnek's "safe zone" (30°-50° inclination and 5°-25° anteversion for the acetabular component) has traditionally been used as a guideline, recent studies have reported significant dislocation rates even within these parameters, highlighting spinopelvic movement abnormalities as a critical factor. Normal spinopelvic-hip mechanics allow for adaptive changes in the pelvis and acetabulum during positional transitions, thereby preventing anterior or posterior impingement in the hip joint. However, patients with restricted lumbosacral mobility are at a greater risk of impingement-related symptoms. To address these challenges, advanced metrics such as sacral slope difference (ΔSS), pelvic-femoral angle (PFA), and combined sagittal index (CSI) have been introduced to better define functional safe zones and assess risks of hip impingement and dislocation. While the relationship between CSI and hip dislocations is established, its impact on hip function remains unclear. This study aims to evaluate the effect of spinopelvic movement on hip function in individuals who have undergone THA. By identifying and preventing complications such as hip pain, mobility restrictions, and dislocations, the research seeks to provide meaningful contributions to the literature and improve patient outcomes.

Eligibility criteria: Inclusion Criteria:

* Patients aged 60 and older.
* At least 12 months post-surgery.

Exclusion Criteria:

* Patients with modular neck implants, metal-metal, or ceramic bearing surfaces.
* Patients with hip infection or advanced osteoarthritis in the contralateral hip.
* Patients with leg length discrepancy.
* Patients with neurological, orthopedic, or systemic diseases affecting gait or balance.
* Patients with a body mass index (BMI) greater than 40 kg/m².

Primary outcomes:
measure: Radiographic Angular Measurements
timeFrame: At least 12 months after surgery
measure: WOMAC (Western Ontario and McMaster Osteoarthritis Index)
timeFrame: At least 12 months after surgery
measure: Harris Hip Score (HHS)
timeFrame: At least 12 months after surgery
measure: Oxford Hip Score
timeFrame: At least 12 months after surgery
measure: SF-12 (Short Form-12 Health Survey)
timeFrame: At least 12 months after surgery
measure: TUG (Timed Up and Go) Test
timeFrame: At least 12 months after surgery
Secondary outcomes:
Other outcomes:
Locations:
city: Ordu
country: Turkey
facility: Ordu University
Study officials:
affiliation: T.C. ORDU ÜNİVERSİTESİ
name: Yusuf POLAT, Assoc.Prof.
role: STUDY_DIRECTOR
affiliation: T.C. ORDU ÜNİVERSİTESİ
name: Elif AYGUN POLAT, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: T.C. ORDU ÜNİVERSİTESİ
name: Murat ALPARSLAN, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: T.C. ORDU ÜNİVERSİTESİ
name: Tolga KECECİ, Assoc.Prof.
role: PRINCIPAL_INVESTIGATOR
affiliation: T.C. ORDU ÜNİVERSİTESİ
name: Alper ÇIRAKLI, Prof.
role: STUDY_CHAIR
References: