In total hip arthroplasty several approaches can be used. The newly introduced minimally invasive anterior approach is supposed to cause less damage to tendons and muscles. At the same time there are reports that there are more complications when this approach is used. The direct lateral approach is the most used in Norway and is well documented. There are however those who postulate that there is to high risk of damage to the gluteus medius causing Trendelenburg gait. In the investigators hospital both the anterior and direct lateral approach is used with good result. The investigators main study hypothesis is that there is no difference between the use of anterior or direct lateral approach i total hip arthroplasty in regards to postoperative function and pain, complications, radiological finds (X-ray and MRI), markers for muscle damage (i.e CK-total) or other clinical outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
The use of direct lateral approach in total hip arthroplasty
The use of anterior approach in total hip arthroplasty
Sorlandet Hospital HF
Arendal, Norway
Change in function
Function of the operated hip will be evaluated after 3, 6, 12 and 24 months using Oxford Hip Score, Harris Hip Score and 6-minute-walk-test. Improvement in general health will be evaluated by using Eq-5D.
Time frame: 2 years
Muscle damage
CK-total is measured direct postoperativly and for the next four consequtive days. CRP is measured the first four postoperative days.
Time frame: Day of operation and next four consecutive days
Pain
Pain using Visual Analog Scale and the use of analgetics (converted to opioid equivalent doses) are recorded.
Time frame: First four postoperative days
X-ray assessment
Placement of the acetabular component (inclination and version) and femoral stem (varus/valgus) and migration.
Time frame: 3 and 12 months
MRI
A subselection of about 40 patients will undergo MRI-scans preoperatively and after 3 and 12 months to assess tendon- and muscledamage.
Time frame: 3 and 12 months
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