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Patients with hip osteoarthritis who were indicated for total hip arthroplasty were prospectively enrolled and randomized to receive either a short (metaphyseal) stem or a conventional (metadiaphyseal) stem hip arthroplasty. Three-dimensional gait analysis was performed regularly (preoperatively and at multiple postoperative time points) to determine whether conservative implants result in superior objective and patient-reported outcomes
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conservative (metaphyseal) stem hip arthroplasty | Active Comparator | Hip arthroplasty is performed through a minimally invasive anterolateral hip approach. All replacements are completely non-cemented, articulations include polyethylene or ceramic inserts on ceramic heads. Cups are standardly fixed through press-fit principle, no additional pelvis screws were standardly used. Special curved femoral reamers are used in order to consume as little bone stock as possible (only the metaphysis) and provide a muscle-sparing approach. |
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| Conventional (metadiaphyseal) stem hip arthroplasty | Active Comparator | Hip arthroplasty is performed through a minimally invasive anterolateral hip approach. All replacements are completely non-cemented, articulations include polyethylene or ceramic inserts on ceramic heads. Cups are standardly fixed through press-fit principle, no additional pelvis screws were standardly used. Standard femoral preparation is performed with prosthesis taking bone stock from the metadiaphyseal area of proximal femur, however, gluteal insertions were preserved in simillar fashion as in metaphyseal implants. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conservative Total Hip Arthroplasty | Procedure | Conservative (metaphyseal) stem Total Hip Arthroplasty |
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| Measure | Description | Time Frame |
|---|---|---|
| 3D Gait analysis - Gait Profile Score | The Gait Profile Score (GPS) is a numerical index (range 0-10, the lesser the number, the better for the patient). The GPS comprises of the kinematic parameteres that are also called the Gait Variable Scores (hip flexion, rotation and abduction) and the spatiotemporal parameters (step time, step length and step cadence). All of these parameters are also mentioned ad separate outcome measures. The extraction of GPS from the 2 basic data groups was done automaticaly through specialised software which is based on the work of Baker et al. (Baker R, McGinley JL, Schwartz MH, et al. The gait profile score and movement analysis profile. Gait Posture. 2009;30(3):265-269. doi:10.1016/j.gaitpost.2009.05.020). | from preoperative to 1 year postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| The Modified Harris Hip Score | Total range of the questionnaire is 0-100 points, more points=better patient reported outcome. 90-100 points = excellent result; 80-89 = good result; 70-79 = fair result; < 70 points = poor result. | from preoperative to 1 year postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Step Time | One of the measured spatiotemporal parameters assessing the duration of a step measured in seconds. The parameter does not have a physiological normative scale. | from preoperative to 1 year postoperative |
| Hip flexion |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Masaryk Hospital | Ústí nad Labem | Ústí nad Labem Region | 40113 | Czechia |
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| Conventional Total Hip Arthroplasty | Procedure | Conventional (metadiaphyseal) stem Total Hip Arthroplasty |
|
One of the kinematic gait parameters = Gait Variable Scores measured in degrees. Physiological range of hip flexion is 0 to 130 degrees, the higher the range, the better for the patient.
| from preoperative to 1 year postoperative |
| Step length | One of the measured spatiotemporal parameters assessing the length of each step measured in meters. The parameter does not have a physiological normative scale. | From preoperative to 1 year postoperative |
| Step cadence | One of the measured spatiotemporal parameters assessing the number of steps in a minute. The parameter does not have a physiological normative scale. | from preoperative to 1 year postoperative |
| Hip external rotation | One of the kinematic gait parameters = Gait Variable Scores measured in degrees. Physiological range of hip eternal rotation is 0 to 60 degrees. The higher the range, the better for the patient. | from preoperative to 1 year postoperative |
| Hip abduction | One of the kinematic gait parameters = Gait Variable Scores measured in degrees. Physiological range of hip abduction is 0 to 45 degress. The higher the range, the better for the patient. | From preoperative to 1 year postoperative |