Gait Analysis and Clinical Outcomes of Anterior and Lateral Approach Total Hip Arthroplasty.

Ain Shams University34 enrolled

Overview

The goal of this Prospective Randomized Study is to confirm presence or absence of differences in gait mechanics in direct anterior and lateral approaches for total hip arthroplasty. and to compare the clinical outcomes of both approaches. The main questions it aims to answer are: if the anterior approach to the hip is faster recovery than lateral approach? if the anterior approach to the hip has better gait mechanics than lateral approach? Participants will: undergo one of the two approaches for total hip arthroplasty. All patients will be followed up at 2 weeks, 6 weeks, 3 months and 18 months. gait analysis will be done at 6wks, 3m, and 18months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

DOUBLE

Enrollment

Conditions

Hip Osteoarthritis

Interventions

Eligibility

Sex: ALLMin age: 20 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with primary osteoarthritis or osteonecrosis of the hip who consented for treatment with a total hip arthroplasty (THA) through an anterior or lateral approach. * Age between 20 - 60 years of age. * The participant had to be independent and physically active, which characterized as having the capacity to carry out daily tasks, ascend two flights of stairs, and able to walk for 15 minutes. Exclusion Criteria: * Patients with bilateral hip affection. * Body mass index (BMI) greater than 40. * Diagnosis other than primary osteoarthritis or osteonecrosis. * Prior hip or spine surgery. * chronic uncontrolled comorbidities, psychological disorders. * American Society of Anaesthesiologists score (ASA) higher than 2 * chronic neurological deficits that influence gait. * any limb length discrepancy more than 1 cm. * Any postoperative complication that will lead to delay in weight bearing.

Outcomes

Primary Outcomes

surgery time

by ''Minute'' as the unit, no special description.

Time frame: intraoperative time starting from skin incision to skin closure

hemoglobin drop

hemoglobin drop level between pre and postoperative.

Time frame: postoperative day one

hospital stays

by ''Day'' as the unit, no special description. postoperative stay days from operation day to discharge day.

Time frame: immediately after the procedure

pain score

using visual analogue scale (VAS) from 0-10 the more scale the worst the pain

Time frame: 2 weeks 6 weeks 3 months 18 months

Harris hip score

for measuring hip function from 0-100 the more the score the better hip function

Time frame: 2 weeks 6 weeks 3 months 18 months

Secondary Outcomes

gait analysis

A single experienced physical medicine specialist will perform the gait analysis in a gait lab. Three-dimensional kinematic and kinetic data will be collected using eight high-speed infrared cameras (Quality motion analysis system, oqus 1 cameras), which can capture 240 frames per second, two force plates (Advanced Mechanical Technology Incorporated, AMTI), and 26 ten-millimeter passive retroreflective markers fixed on the subject using a double-face tape in specific landmarks on the subject in accordance to the modified institute Orthopedic Rizzoli (IOR ) model for full body marker set.

Time frame: at 6 weeks, 3 months, 18 months