Gait Initiation and Transition From Double to Single Support in Patients With Unilateral Primary Coxarthrosis

Lille Catholic University100 enrolled

Overview

The study consists to evaluate the impact of prosthetic surgery (PTH and RTH) on kinematic and dynamic parameters (joint torques) of the lower limbs during gait initiation in patients with primary coxarthrosis. Patients included in the study will undergo a three-dimensional gait analysis. Dynamic gait analysis is multidimensional, measuring kinematic parameters (joint amplitudes: ankles, knees, hips, etc.) and dynamic parameters (assessment of joint torque from ankle, knee, hip to lower limb during gait initiation).

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

100

Conditions

Primary; Coxarthrosis

Interventions

Patients with primary coxarthrosis (any stage).

Patients with primary coxarthrosis (any stage) and operated with Total Hip Prosthesis (THP).OTHER

Patients scheduled for THP (Total Hip Prosthesis) will be seen at the consultation the day before surgery, in the same hospital as the THP, or at an existing dedicated consultation scheduled for all THP patients. During these scheduled visits, they will be received in the gait analysis laboratory for a gait assessment (V1). Patients will be seen again at 6 months post-operatively for a second gait assessment (V2).

Patients with primary coxarthrosis (any stage) and operated with RTH (Hip resurfacing).OTHER

Patients scheduled for RTH (Hip Resurfacing) will be seen at the consultation the day before surgery, in the same hospital as the RTH, or at an existing dedicated consultation scheduled for all RTH patients. During these scheduled visits, they will be received in the gait analysis laboratory for a gait assessment (V1). Patients will be seen again at 6 months post-operatively for a second gait assessment (V2).

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Men or women aged 18 and over * With primary coxarthrosis (any stage) * Consulting in the orthopedic departments of participating centers in anticipation of hip surgery (PTH/RTH), or for advice only. * Written consent signed by the patient * Affiliation with a social security scheme Exclusion Criteria: * Disabling orthopaedic conditions: Symptomatic contralateral hip/knee disease Symptomatic gonarthrosis or homolateral total knee prosthesis History of surgery on the affected hip History of fracture of the lower limb in the past year History of lower limb sprain in the last 3 months Neurological or degenerative disease * Pregnant or breast-feeding * Adults under guardianship, curatorship or safeguard of justice * Cognitive impairment making it impossible to understand the protocol * Approach other than Moore posterolateral (for PTH and RTH groups)

Locations (2)

CHU de Lille

Lille, France

NOT_YET_RECRUITING

Hôpital Saint-Philibert (GHICL)

Lomme, France

RECRUITING

Outcomes

Primary Outcomes

Amplitude degree of lower limbs articulations

Time frame: 6 months

Dynamics of limbs joint torques during walking initiation measured in Nm/kg

Time frame: 6 months

Secondary Outcomes

Step length during gait initiation

Time frame: 6 months

Step width during gait initiation

Time frame: 6 months

Duration of first step during gait initiation

Time frame: 6 months

Duration of anticipatory postural adjustment phase during gait initiation

Time frame: 6 months

Duration of execution phase during gait initiation

Time frame: 6 months

Measurement of the trajectory during gait initiation

Time frame: 6 months

Measurement of the speed during gait initiation

Time frame: 6 months

Measurement of the amplitude of retreat of the center of pressure during gait initiation

Time frame: 6 months

Severity of coxarthrosis according to the Tönnis classification

The severity of coxarthrosis is assessed on radiographs according to the Tönnis classification: Grade Radiographic features 0 - No signs of osteoarthritis 1. \- Slight narrowing of joint space * Slight lipping at joint margin * Slight sclerosis of the femoral head or acetabulum 2. \- Small cysts in the femoral head or acetabulum * Increasing narrowing of joint space * Moderate loss of sphericity of the femoral head 3. \- Large cysts * Severe narrowing or obliteration of joint space * Severe deformity of the femoral head * Avascular necrosis

Time frame: 6 Months

HHS (Harris Hip Score)

The functional score consists of 10 items out of 100 points (best score = 100 points) assessing function, pain and mobility

Time frame: 6 months

PMA (Postel Merle d'Aubigné) score

Score on 3 items (pain, mobility and walking) rated on 18 points (18 = excellent results, 0 = worst result)

Time frame: 6 months

Devane score

Activity score with 5 possibilities (1 = sedentary work and 5 = power work, competitive sport)

Time frame: 6 months

UCLA (University of California Los Angeles) score

Activity score comprising 10 possibilities and assessing the intensity of physical activity (1= inactive or dependent patient, 10 = regular practice of high-impact sports)

Time frame: 6 months

Vellas unipodal weight-bearing test

This test consists in asking the patient to balance for as long as possible. A time of more than 30 seconds indicated a very low risk of falls. A time of less than 5 seconds indicates a very high risk of falls.

Time frame: 6 months

Pelvic incidence

Pelvic incidence is a constant morphologic parameter that describes the "pelvic size" based on the angular relation between femoral heads and sacral plate for any given person

Time frame: 6 months

Sacral slope angle

Spatial orientation of the pelvis in the sagittal plane is assessed by the sacral slope

Time frame: 6 months

Pelvic tilt angle

Pelvic tilt is a position-dependent parameter defined as the angle created by a line running from the sacral endplate midpoint to the center of the bifemoral heads and the vertical axis.

Time frame: 6 months

Central Contacts

Marie-Paule LEBITASY

CONTACT

+33 3 20 22 52 69 urm@ghicl.net

William's VAN DEN BERGHE

CONTACT

+33 3 20 22 57 31 VanDenBerghe.Williams@ghicl.net