The purpose of this study is to investigate the effectiveness of a hip arthroplasty for chronic pain, caused by a unilateral primary Coxartrhrose, regarding the cognitive performance. It is based on the hypothesis that the combination of chronic pain along with relative immobilization causes impairment of cognitive performance. The total hip replacement reduces pain, increases the mobility level and finally improves the cognitive performance.
Studies have shown that cognitive performance, especially in the elderly is limited due to chronic pain. In a recent study, significantly less brain activity in various regions of the brain (the anterior cingulate cortex (ACC), insula and operculum, dorsolateral prefrontal cortex and orbitofrontal cortex) was detected in patients with unilateral primary coxarthrosis compared to a healthy control group. After eliminating the pain by the implantation of a total hip replacement, a significant increase in brain activity in the affected areas was observed in these patients. Whether this observation is accompanied by an effect on cognition, is not known and will be investigated in the proposed study. The purpose of this study is to investigate the effectiveness of a hip arthroplasty for chronic pain, caused by a unilateral primary Coxartrhrose, regarding the cognitive performance. It is based on the hypothesis that the combination of chronic pain along with relative immobilization causes impairment of cognitive performance. The total hip replacement reduces pain, increases the mobility level and finally improves the cognitive performance. The main issue concerns the short and mid-term influence of hip replacement on cognitive performance in the perioperative care continuum in comparison to a control group that does not have chronic pain. To objectively quantify the everyday activity, there are a variety of instruments, without a currently gold standard. Therefore, in addition the investigators use objectified measurement parameters with the aid of a pedometer (GARMIN vivofit) on every three measuring time points (before surgery, 3 months after surgery, 6 months after surgery). Standardized neuropsychological assessment methods are used to assess the cognitive performance. To assess the degree of mobility, health status and the physical activity standardized questionnaires are used. Primary hypothesis: After implantation of an artificial hip replacement and reduction of experienced pain patients with primary coxarthrosis indicate an improvement of cognitive performance 3 and 6 month after surgery compared to the pre-surgical status. In addition, the investigators measure how severe the cognitive performance is reduced compared to a healthy control group prior to surgery and to what extend the cognitive performance is reversible in the aftermath.
Study Type
OBSERVATIONAL
Enrollment
260
To objectively quantify the everyday activity, there are a variety of instruments, without a currently gold standard. Therefore, in addition the investigators use objectified measurement parameters with the aid of a pedometer (GARMIN vivofit) on every three measuring time points (before surgery, 3 months after surgery, 6 months after surgery).
Standardized neuropsychological assessment methods are used to assess the cognitive performance. To assess the degree of mobility, health status and the physical activity standardized questionnaires are used.
Klinikum Bad Bramstedt
Bad Bramstedt, Germany
RECRUITINGUniversitätsklinikum Hamburg-Eppendorf
Hamburg, Germany
RECRUITINGattention and concentration performance (assessed by d2 Test of Attention)
Time frame: Change from Baseline attention and concentration performance at 6 months
conceptual tracking, planning and flexibility (assessed by Trail Making Tests (Parts A and B)
Time frame: Change from Baseline conceptual tracking, planning and flexibility at 6 months
semantic memory (assessed by FAS-Test [Verbal Fluency])
Time frame: Change from Baseline semantic memory at 6 months
verbal episodic memory (Rivermead Behavioural Memory Test (RBMT) - story recall subtest) subtest
Time frame: Change from Baseline verbal episodic memory at 6 months
visuospatial constructional ability and visual memory (assessed by Rey-Osterrieth Complex Figure Test)
Time frame: Change from Baseline visuospatial constructional ability and visual memory at 6 months
subjective physical activity (assessed by Physical Activity Scale for the Elderly (PASE))
Time frame: Change from Baseline subjective physical activity at 6 months
objective physical activity (assessed by pedometer GARAMIN vivofit)
Time frame: Change from Baseline objective physical activity at 6 months
anxiety (assessed by the Generalized Anxiety Disorder 7-Scale (GAD-7))
Time frame: Change from Baseline anxiety at 6 months
depression (assessed by the Patient Health Questionnaire (PHQ-9))
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Time frame: Change from Baseline depression at 6 months
quality of life (assessed by the SF-12 health survey)
Time frame: Change from Baseline quality of life at 6 months