The effect of posterior and lateral approach on patient-reported outcome measures and physical function in patients with osteoarthritis, undergoing total hip replacement: a randomised controlled trial protocol

Projekter: ProjektForskning



Background: Total hip replacement provides pain relief and improves physical function and quality of life in patients
with end-stage hip osteoarthritis. The incidence of hip replacement operations is expected to increase due to the
growing elderly population. Overall, the posterior approach and lateral approach are the two most commonly used
approaches for hip replacement operations. The posterior approach is associated with an increased risk of revision due
to dislocations, and some studies have shown that the lateral approach is associated with reduced patient-reported
outcomes, including physical function and pain; however, this has not been investigated in a randomised controlled
trial with a twelve-month follow-up. We hypothesized that the lateral approach has an inferior outcome in
patient-reported outcome compared with the posterior approach after one year.
Methods/Design: The trial is a prospective, double blinded, parallel-group controlled trial with balanced
randomisation [1: 1]. Patients with hip osteoarthritis scheduled for hip replacement surgery, aged 45–70 years,
will be consecutively recruited and randomised into two groups. Group A will receive hip replacement using the
posterior approach, and Group B will receive hip replacement using the lateral approach. The primary end-point
for assessing the outcome of the two interventions will be twelve months after surgery. Follow-up will also be
performed after three and six months. The primary outcome is Hip Disability and Osteoarthritis Outcome Score,
subscale of “Physical function Short form” (HOOS-PS) Secondary outcome measures include two other subscales
of HOOS (“Pain” and “Hip related Quality of Life”), physical activity level (UCLA activity score), limping (HHS) and
general health status (EQ-5D-3L). Explorative outcomes include physical function test, 3D-gait-analysis and
muscle strength.
Discussion: To our knowledge, this is the first randomised controlled trial comparing the posterior approach with the
lateral approach with patient reported outcome as the primary outcome and with a twelve-month follow-up.
Effektiv start/slut dato01/08/201401/08/2017


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