Gait Analyses After Resurfacing Hip Arthroplasty Versus Metal on Metal Total Hip Arthroplasty, an Exploratory Study

Overview

Total hip replacement surgery is a very successful operation with good long-term results. Hip resurfacing arthroplasty is offered as a treatment option for young and active patients with osteoarthritis of the hip. It has been proposed as a treatment option for younger patients because of claims that it preserves femoral bone stock and has better functional outcomes. The assessment of gait after hip replacement surgery may be able to determine functional differences between patients who have undergone total hip replacement / arthroplasty (THA) versus hip resurfacing.

Full Title of Study: “Gait Analyses After Resurfacing Hip Arthroplasty Versus Metal on Metal Total Hip”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Non-Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Basic Science
    • Masking: Single (Investigator)
  • Study Primary Completion Date: December 2015

Detailed Description

A group of 58 patients, part of a ungoing randomized trial comparing resurfacing hip arthroplasty to metal-on-metal total hip arthroplasty, will be invited to a single gait analysis on a trendmill. All patients have reached a follow up of five years. Patient 's gait will be assessed during two walking sessions, in both sessions spatio-temporal, kinetic and kinematic parameters will be recorded. – At first when flat walking with increasing speeds to their top walking speed. – Secondly: when walking at a fixed speed with an increasing incline to their top walking incline.

Interventions

  • Other: Gait analysis on a trendmill
    • Gait analysis on a trendmill “GRAIL” to analyse spatio-temporal kinetics and kinematics when flat walking and inclining

Arms, Groups and Cohorts

  • Active Comparator: Total Hip Arthroplasty
    • Gait analysis on a trendmill of patients with a well functioning total hip arthroplasty on a trendmill
  • Active Comparator: Resurfacing Hip Arthroplasty
    • Gait analysis on a trendmill of patients with a well functioning resurfacing hip arthroplasty on a trendmill

Clinical Trial Outcome Measures

Primary Measures

  • Top walking speed
    • Time Frame: 5 years postoperative
    • Mean top walking speed in kilometers / hour assessed on a trendmill
  • Walking cadence
    • Time Frame: 5 years postoperative
    • Mean steps / minute at top walking speed assessed on a trendmill
  • Step length
    • Time Frame: 5 years postoperative
    • Mean step distance in meters at top walking speed assessed on a trendmill
  • Maximum Push off force (N/kg) per cycle
    • Time Frame: 5 years postoperative
    • Mean ground reaction forces in Newton / kilogram on a trendmill
  • Maximum weight acceptance (N/kg) per cycle
    • Time Frame: 5 years postoperative
    • Mean ground reaction forces assessed on a trendmill
  • Mid-stance force (N/kg) per cycle
    • Time Frame: 5 years postoperative
    • Mean ground reaction forces assessed on a trendmill
  • Hip maximum flexion/extension per cycle
    • Time Frame: 5 years postoperative
    • Mean hip kinematics in degrees assessed on a trendmill
  • Hip maximum internal/external rotation per cycle
    • Time Frame: 5 years postoperative
    • Mean hip kinematics in degrees assessed on a trendmill

Secondary Measures

  • Postoperative hip functionality after hip arthroplasty.
    • Time Frame: 5 years postoperative
    • Postoperative hip function according the Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index
  • General Health according EurQol-5D
    • Time Frame: 5 years postoperative
    • Health outcome on the EQ-5D questionairre
  • Physical activity level according the UCLA-activity score
    • Time Frame: 5 years postoperative
    • The University of California at Los Angeles (UCLA) activity score

Participating in This Clinical Trial

Inclusion Criteria

  • Patient part of randomised controlled trial (RCT) of hip resurfacing versus MoM total hip arthroplasty for symptomatic osteoarthritis of the hip – Patient must be able to consent to the study (written informed consent) – Patients who are functioning well post-operatively and not under routine follow up – Patients who are able to walk without any safety rail assistance on the treadmill Exclusion Criteria:

  • Patient not originally randomised during an RCT of hip resurfacing versus MoM total hip arthroplasty – Patients who suffer from any neurological or musculoskeletal conditions that might make a gait test dangerous. – Patients whose cognitive function prevents them from understanding the study – Patients who have had or are awaiting revision surgery for their hip

Gender Eligibility: All

Minimum Age: 40 Years

Maximum Age: 75 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Rijnstate Hospital
  • Collaborator
    • RMC Groot Klimmendaal
  • Provider of Information About this Clinical Study
    • Principal Investigator: Job van Susante, Dr. JLC van Susante – Rijnstate Hospital
  • Overall Official(s)
    • Job LC Susante, Dr, Principal Investigator, Rijnstate Hospital, orthopedic surgeon

References

Aqil A, Drabu R, Bergmann JH, Masjedi M, Manning V, Andrews B, Muirhead-Allwood SK, Cobb JP. The gait of patients with one resurfacing and one replacement hip: a single blinded controlled study. Int Orthop. 2013 May;37(5):795-801. doi: 10.1007/s00264-013-1819-3. Epub 2013 Feb 27.

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