During direct anterior approach (DAA) for total hip arthroplasty (THA), ligation of the lateral femoral circumflex artery and vessel is always conducted. However, this standardized procedure may jeopardize blood muscle perfusion and cause tenderness in the tensor fascia lata muscle. The investigators want to investigate whether blood vessel-sparing surgery is feasible, reproducible, and would alter outcomes following DAA THA. The surgical technique of the vessel-sparing procedure will be described and investigated in a prospective blinded RCT. The investigators hypothesize that the vessel-sparing technique is feasible in 60% of the patients. If these vessels were not sacrificed, the investigators expect the incidence of TFL tendinopathy to be lower.
Primary objective: to compare a group with successful vessel-sparing with a vessel-sacrificed-group for: 1. Incidence of TFL tendinopathy 2. Patient-reported outcomes 3. Component placement Secondary objective: to observe the feasibility of the vessel-sparing surgical technique. This is a monocentric prospective randomized blinded clinical trial during a period of minimum 3 years or until 150% of the sample size is included (100 patients).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
300
Vessel sparing
Vessel ligation
Ziekenhuis Oost-Limburg
Genk, Limburg, Belgium
RECRUITINGa) Incidence of TFL tendinopathy
Clinical examination to detect TFL tendinopathy
Time frame: one year follow-up
b-1) Patient-reported outcome 1: modified Harris Hip Score (HHS)
modified Harris Hip Score (HHS) minimum (worse) score = 0 maximum (best) score = 44
Time frame: one year follow-up
b-2) Patient-reported outcome 2: Hip And Groin Outcome Score (HAGOS)
Hip And Groin Outcome Score (HAGOS) minimum (worse) score = 0 maximum (best) score = 100
Time frame: one year follow-up
b-3) Patient-reported outcome 3: Forgotten Joint Score
Forgotten Joint Score minimum (worse) score = 0 maximum (best) score = 100
Time frame: one year follow-up
b-4) Patient-reported outcome 4: Hip disability and Osteoarthritis Outcome Score (HOOS).
Hip disability and Osteoarthritis Outcome Score (HOOS) minimum (worse) score = 0 maximum (best) score = 100
Time frame: one year follow-up
c) Component placement (x-rays)
Using pelvic anteroposterior radiographs, with both legs internally rotated 15°: Acetabular version (Lewinnek method). Acetabular inclination Femoral alignment Under-sizing in case the femoral component is not touching cortical bone.
Time frame: one year follow-up
Vessel sparing succesfull
Successful Yes/No
Time frame: end of surgery
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