Comparison of Muscle Atrophy After Direct Anterior & Posterior Total Hip Arthroplasty

The Influence of Operative Approach on Muscle Atrophy After Total Hip Arthroplasty: A Comparison of Anterior and Posterior Approaches

This project is designed to use MRI to evaluate pre- and post-arthroplasty hips; the specific aims of this project are three-fold. First, the investigators intend to compare the amount of muscle atrophy and tendon damage that occurs around the hip between two commonly-used operative approaches: the direct-anterior approach and the posterior approach. Second, the investigators aim to provide baseline data on the amount of muscle atrophy and tendon damage that should reasonably be expected to occur with both of these approaches. Third, the investigators will document the degree of recovery of the periprosthetic soft tissues post-surgery in both patient groups.

The investigators first hypothesis is that the posterior approach will demonstrate significantly more damage to the abductors, piriformis, and short external rotators than the direct anterior approach, which will demonstrate minimal soft tissue damage. The investigators second hypothesis is that both surgical approaches will cause some degree of baseline muscle damage and atrophy, in a predictable pattern. The investigators third hypothesis is that each of the surgical approaches inherently cause some degree of soft tissue damage, and that the periprosthetic soft tissues that are incised during the surgical exposure will recover in a predictable pattern which is consistent but unique within each group

Study Overview

• Status: Completed
• Conditions: Osteoarthritis, Hip

• Study Type: Observational
• Enrollment (Actual): 19

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10075
      • NorthShoreLIJ/LenoxHill Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing Total Hip arthroplasty by one of the two fellowship trained arthroplasty surgeons.

Description

Inclusion Criteria:

1. Patients undergoing elective, primary total hip arthroplasty
2. Use of Cementless Total Hip components
3. Preoperative diagnosis of degenerative joint disease secondary to osteoarthritis

Exclusion Criteria:

1. Prior surgery on the affected hip
2. No implanted medical devices or metallic debris in the patient which will preclude use of MRI
3. patients must be able to participate in standard post-arthroplasty rehabilitation protocols.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Direct Anterior Approach
Posterior Approach

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in muscle volume at 6 weeks	Muscle volume will be recorded in MRI images with specialized software (external rotators,tensor fascia lata, rectus femoris,gluteus medius and minimus)	6 weeks after surgery
Change from baseline in muscle volume at 6 months		6 months after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Fatty atrophy of muscles from baseline at 6weeks	Qualitative assessment of fatty atrophy	6 weeks after surgery
tendon damage	Qualitative assessment of tendon damage on MRI	6 weeks after surgery
Change in fatty atrophy of muscles from baseline at 6 months		6 months after surgery
Tendon damage		6 months after surgery

Collaborators and Investigators

• Sponsor: Northwell Health
• Investigators: Principal Investigator: Jose A Rodriguez, MD, NorthShoreLIJ/LenoxHill Hospital

Study record dates

Study Major Dates

• Study Start: May 1, 2012
• Primary Completion (Actual): July 1, 2021
• Study Completion (Actual): July 1, 2021

Study Registration Dates

• First Submitted: June 29, 2012
• First Submitted That Met QC Criteria: July 9, 2012
• First Posted (Estimate): July 10, 2012

Study Record Updates

• Last Update Posted (Actual): November 19, 2021
• Last Update Submitted That Met QC Criteria: November 17, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Neuromuscular Manifestations; Pathological Conditions, Anatomical; Osteoarthritis; Muscular Atrophy; Osteoarthritis, Hip; Atrophy
• Other Study ID Numbers: MRI DAA/PA