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The purpose of our study is to evaluate the differences in functional activities and proprioception after surgery in subjects who underwent hip prosthesis implant with capsulotomy or capsulectomy.
Concerning hip arthroplasty surgery, in patients affected by coxarthrosis, there are two different techniques: one is capsulectomy and the second one is capsulotomy with repairing the capsule at the end of the procedure. Both preserving and excising the capsule are accepted methods and the choice whether repairing the capsule or not is up to the surgeon, since studies have not yet demonstrated the superiority of one of the two techniques. Articular capsule has a physiological role in joint stability and proprioception. The presence of proprioceptive nerve endings in hip joint capsule has been observed both in healthy patients and in those affected by coxarthrosis.
If capsulectomy is performed during primary hip arthroplasty, the pseudocapsule that is formed in place of the native capsule will not have any active neurophysiological role in the hip.
For this reason, investigators compare the two surgical techniques with the purpose of highlighting, if existing, the superiority of one technique on the other in terms of better functional recovery and proprioceptive sensibility.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Capsulectomy | Other | Procedure: Capsulectomy in Direct Anterior Total Hip Arthroplasty |
|
| Capsulotomy | Other | Procedure: Capsulotomy in Direct Anterior Total Hip Arthroplasty |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Capsulectomy in Direct Anterior Total Hip Arthroplasty | Procedure | Surgical intervention in which the surgeon will perform anterior capsulectomy during total hip arthroplasty. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Hip disability and Osteoarthritis Outcome Score (HOOS) | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | |
| Change in Hip disability and Osteoarthritis Outcome Score (HOOS) | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Six minutes walk test distance | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | |
| Change in Six minutes walk test distance | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marco Ometti, MD | IRCCS San Raffaele | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| San Raffaele Hospital | Milan | 20132 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11805930 | Background | Hewitt JD, Glisson RR, Guilak F, Vail TP. The mechanical properties of the human hip capsule ligaments. J Arthroplasty. 2002 Jan;17(1):82-9. doi: 10.1054/arth.2002.27674. | |
| 18237703 | Background | Martin HD, Savage A, Braly BA, Palmer IJ, Beall DP, Kelly B. The function of the hip capsular ligaments: a quantitative report. Arthroscopy. 2008 Feb;24(2):188-95. doi: 10.1016/j.arthro.2007.08.024. Epub 2007 Nov 26. |
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| ID | Term |
|---|---|
| D015207 | Osteoarthritis, Hip |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| Capsulotomy in Direct Anterior Total Hip Arthroplasty | Procedure | Surgical intervention in which the surgeon will perform anterior capsulotomy during total hip arthroplasty. Surgeon will repair the joint capsule. |
|
| Change in 30 seconds chair stand test | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Change in 30 seconds chair stand test | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Hip Proprioception Evaluation Flexion - Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip flexion repositioning error (active and passive repositioning) | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Hip Proprioception Evaluation Abduction - Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip abduction repositioning error (active and passive repositioning) | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Hip Proprioception Evaluation External Rotation- Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip external rotation repositioning error (active and passive repositioning) | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Hip Proprioception Evaluation Flexion- Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip flexion repositioning error (active and passive repositioning) | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Hip Proprioception Evaluation Abduction - Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip abduction repositioning error (active and passive repositioning) | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Hip Proprioception Evaluation External Rotation- Measure of the absolute difference between the actual and the subject-replicated target positions. | Measures of hip external rotation repositioning error (active and passive repositioning) | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Active hip Range Of Motion Flexion- degree | Measures of hip flexion maximal active Range of Motion | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Active hip Range Of Motion Abduction- degree | Measures of hip abduction maximal active Range of Motion | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Active hip Range Of Motion External Rotation- degree | Measures of hip external rotation maximal active Range of Motion | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
| Active hip Range Of Motion Flexion- degree | Measures of hip flexion maximal active Range of Motion | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Active hip Range Of Motion Abduction- degree | Measures of hip abduction maximal active Range of Motion | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Active hip Range Of Motion External Rotation- degree | Measures of hip external rotation maximal active Range of Motion | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) |
| Surgical time- minutes | This will be measured from the time of incision to the time the dressing is applied | The day of the surgical procedure |
| Percent hemoglobin drop | Percent hemoglobin drop will be measured by comparing the preoperative hemoglobin to the inpatient nadir hemoglobin. | Up to 2 weeks after surgery (during inpatient stay) |
| 9479711 | Background | Birnbaum K, Prescher A, Hessler S, Heller KD. The sensory innervation of the hip joint--an anatomical study. Surg Radiol Anat. 1997;19(6):371-5. doi: 10.1007/BF01628504. |
| 22087603 | Background | Moraes MR, Cavalcante ML, Leite JA, Macedo JN, Sampaio ML, Jamacaru VF, Santana MG. The characteristics of the mechanoreceptors of the hip with arthrosis. J Orthop Surg Res. 2011 Nov 16;6:58. doi: 10.1186/1749-799X-6-58. |
| 22588756 | Background | Bennell K, Dobson F, Hinman R. Measures of physical performance assessments: Self-Paced Walk Test (SPWT), Stair Climb Test (SCT), Six-Minute Walk Test (6MWT), Chair Stand Test (CST), Timed Up & Go (TUG), Sock Test, Lift and Carry Test (LCT), and Car Task. Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S350-70. doi: 10.1002/acr.20538. No abstract available. |
| 12777182 | Background | Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003 May 30;4:10. doi: 10.1186/1471-2474-4-10. Epub 2003 May 30. |
| 31680746 | Derived | Ometti M, Brambilla L, Gatti R, Tettamanti A, La Cava T, Pironti P, Fraschini G, Salini V. Capsulectomy vs capsulotomy in total hip arthroplasty. Clinical outcomes and proprioception evaluation: Study protocol for a randomized, controlled, double blinded trial. J Orthop. 2019 Sep 12;16(6):526-533. doi: 10.1016/j.jor.2019.09.020. eCollection 2019 Nov-Dec. |
| D012216 |
| Rheumatic Diseases |