Surgical Approaches for Hip Arthritis
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to study how different types of hip replacement surgeries affect walking. It compares three methods: manual surgery from the front of the hip (total hip arthroplasty via direct anterior approach), manual surgery from the back (total hip arthroplasty via posterior approach), and robotic-assisted surgery from the back (robotic-assisted total hip arthroplasty via posterior approach). The researchers seek to determine which approach best improves walking after surgery. Individuals with hip arthritis who can walk more than 150 feet without assistance and have not had previous hip surgery might be suitable candidates for this trial. As an unphased trial, this study offers a unique opportunity to contribute to understanding the best surgical methods for enhancing mobility.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that these surgical approaches are safe for hip arthritis treatment?
Research shows that robotic-assisted total hip replacement using the posterior approach is generally well-received by patients. This method reduces the likelihood of needing another surgery due to hip dislocation and enhances hip movement and comfort post-operation. Patients report better outcomes on tests measuring hip function and comfort.
For the manual direct anterior approach, earlier studies suggest it allows for quicker recovery and has a lower risk of dislocation. However, there may be a higher risk of temporary nerve issues in the thigh. Most patients handle this approach well, but it requires a skilled surgeon.
The manual posterior approach is the most common method worldwide. It provides good access to the hip and maintains muscle function. Some research indicates it might have a higher risk of dislocation, but careful surgical techniques can mitigate this risk. Overall, it is considered safe with proper care.
Each of these surgical methods has its advantages and disadvantages, but they are all generally safe, with experienced surgeons managing any risks.12345Why are researchers excited about this trial?
Researchers are excited about these surgical approaches for hip arthritis because they each bring unique advantages to the table. The robotic-assisted posterior approach stands out by integrating computer-navigated precision, enhancing implant alignment and biomechanical restoration with tools like MAKO systems, which provide intraoperative guidance and preoperative planning. The manual direct anterior approach offers a less invasive route by preserving key soft tissues, potentially reducing dislocation rates and speeding up recovery, albeit with a challenging learning curve. Meanwhile, the manual posterior approach remains popular due to its extensive exposure and maintained abductor function, though it requires careful repair to minimize dislocation risks. Each method provides a distinct balance of benefits that could improve patient outcomes.
What evidence suggests that this trial's surgical approaches could be effective for hip arthritis?
This trial will compare different surgical approaches for hip arthritis. Research has shown that using robotic assistance for total hip replacement through the back of the hip, one of the approaches in this trial, allows precise placement of the new joint and reduces the chance of dislocation. Studies indicate that this method enhances joint function and increases patient satisfaction by ensuring better alignment and function. Another approach in this trial is the manual approach from the front of the hip, which evidence suggests helps preserve muscles and shortens recovery time, although there may be a risk of nerve problems. The manual approach from the back, also studied in this trial, is popular due to easier access, but it carries a higher risk of dislocation unless the surrounding tissues are carefully repaired. Overall, each method has proven effective in improving hip function and patient outcomes.34567
Who Is on the Research Team?
George Chimento, MD
Principal Investigator
Ochsner Health System
Are You a Good Fit for This Trial?
This trial is for individuals with hip arthritis or osteoarthritis who need a total hip replacement. It's not specified, but typically participants should be adults in stable health without conditions that could affect their gait or surgery outcomes.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Pre-operative Assessment
Gait and sit-to-stand analyses are performed pre-op using a Vicon motion capture system with force plates and surface EMG
Surgery and Initial Recovery
Participants undergo total hip arthroplasty via manual direct anterior, manual posterior, or robotic-assisted posterior approach
Post-operative Follow-up
Gait biomechanics and patient-reported outcomes are assessed at 6 and 12 weeks post-op
Long-term Follow-up
Participants are monitored for postoperative complications and patient-reported outcomes up to 12 months
What Are the Treatments Tested in This Trial?
Interventions
- Robotic-assisted total hip arthroplasty via posterior approach
- Total hip arthroplasty via direct anterior approach (manual, non-robotic)
- Total hip arthroplasty via posterior approach (manual, non-robotic)
Find a Clinic Near You
Who Is Running the Clinical Trial?
Ochsner Health System
Lead Sponsor