La traction sans appui périnéal en arthroscopie de la hanche peut-elle réduire efficacement les complications périnéales ?
La traction sans périnée dans l'arthroscopie de la hanche peut-elle réduire efficacement les complications périnéales ? Un essai contrôlé randomisé prospectif multicentrique
The goal of this clinical trial is to analyze the impact of perineal post-free traction versus traditional perineal post traction on perineal complications in hip arthroscopy. The main question it aims to answer is:
• Can Perineal Post-Free Traction in Hip Arthroscopy Effectively Reduce Perineal Complications? Researchers will compare the perineal-post-free traction group with the conventional perineal-post traction group to see if the former decreases perineal complications and improves efficiency without compromising surgical outcomes.
Participants will:
- Undergo either perineal-post-free or standard perineal-post traction during hip arthroscopy
- Complete nerve-injury checks on day 1 and at discharge, and hip-function questionnaires (VAS, mHHS, IHOT-12, HOS) at 3 months
- Allow collection of operating times, hospital stay, and direct medical costs for economic analysis
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Type d'étude
Type d'étude
Inscription (Estimé)
Inscription
Phase
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Beijing Municipality
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Beijing, Beijing Municipality, Chine, 100143
- Chinese PLA General Hospital
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Guangdong
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Shenzhen, Guangdong, Chine, 518035
- Shenzhen Second People's Hospital
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Henan
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Luoyang, Henan, Chine, 471002
- Luoyang Orthopedic Traumatological Hospital of Henan
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Jiangsu
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Nanjing, Jiangsu, Chine, 210008
- The Affiliated Drum Tower Hospital, Medical School of Nanjing University
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Shaanxi
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Xi'an, Shaanxi, Chine, 710038
- The Second Affiliated Hospital of Air Force Medical University (AFMU)
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Shandong
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Tai’an, Shandong, Chine, 271000
- The Second Affiliated Hospital of Shandong First Medical University
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Chine, 200080
- Shanghai General Hospital
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Sichuan
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Chengdu, Sichuan, Chine, 610041
- West China Hospital, Sichuan University
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Yunnan
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Kunming, Yunnan, Chine, 650032
- The First Affiliated Hospital of Kunming Medical University
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Zhejiang
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Hangzhou, Zhejiang, Chine, 310006
- Zhejiang Provincial Hospital of Chinese Medicine
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Aged 15 to 60 years;
- Met the diagnostic criteria of femoroacetabular impingement syndrome (FAI) and indicated for hip arthroscopy based on patient history, symptoms, signs, physical examination, imaging (pelvic anteroposterior view, frog-leg view, CT 3D reconstruction, MRI), and diagnostic injections;
- Able to read and sign the informed consent form.
Exclusion Criteria:
- History of high-energy hip trauma, previous ipsilateral or contralateral hip surgery, avascular necrosis of the femoral head, slipped capital femoral epiphysis, Perthes disease, severe osteoporosis, tumors, acetabular stress fractures, or proliferative or immune hip diseases;
- Diseases causing groin numbness, foot numbness, sexual dysfunction, urinary dysfunction, skin injuries, perineal injuries, nerve injuries, radicular pain, inner or outer thigh numbness;
- Abnormal heart, lung, liver, kidney function, severe coagulation disorders, poorly controlled diabetes, judged by the researcher to have an infection risk;
- Consciousness disorders, psychiatric disorders, or neuromuscular dysfunction affecting lower limb function;
- Active infection foci (systemic or local infectious lesions);
- Pregnancy, lactation, or planned pregnancy during the clinical study period;
- Participation in another clinical trial within the past 3 months;
- Patients deemed unsuitable for the clinical trial by the researcher for other reasons.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
|---|---|
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Expérimental: Traction sans Poste Périnéal
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Traction achieved with a thoraco-abdominal belt and contralateral groin strap; operating table tilted 10-15° Trendelenburg under fluoroscopy to 8-10 mm joint space. No perineal post is used, eliminating direct perineal pressure. |
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Comparateur actif: Traction du périnée après l'accouchement
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Standard traction table with padded perineal post placed against the groin providing counter-traction; affected limb distracted under fluoroscopy to 8-10 mm joint space while contralateral limb is abducted. |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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The incidence of perineal nerve injury
Délai: The first day after surgery
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The incidence of perineal nerve injury included: perineal numbness, pain, soft tissue injury, sexual function and urinary dysfunction. |
The first day after surgery
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Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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The incidence of pain, numbness, soft tissue injury in other places
Délai: The first day after surgery
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Lower limb ankle numbness and soft tissue injury; the contralateral groin pain, numbness and soft tissue injury; chest pain, numbness, soft tissue injury with fixed place |
The first day after surgery
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Patients at discharge perineum area incidence of nerve injury
Délai: 7 days after surgery
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Patients at discharge perineum area incidence of nerve injury include: perineum area numbness, pain, soft tissue injuries, sexual and urinary dysfunction. |
7 days after surgery
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Intraoperative traction time
Délai: During surgery (intraoperatively)
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Intraoperative traction time |
During surgery (intraoperatively)
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Preoperative preparation time
Délai: Immediately before surgery (preoperatively)
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Preoperative preparation time |
Immediately before surgery (preoperatively)
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Operating time
Délai: During surgery (intraoperatively)
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Operating time |
During surgery (intraoperatively)
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The average length of hospital stay after surgery
Délai: 6 weeks after surgery
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The average length of hospital stay after surgery |
6 weeks after surgery
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Postoperative joint function assessment
Délai: 3 months after surgery
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Visual Analog Scale (VAS) (range 0-10; higher scores indicate worse outcomes). |
3 months after surgery
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Postoperative joint function assessment
Délai: 3 months after surgery
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Modified Harris Hip Score (mHHS) (range 0-100; higher scores indicate better outcomes). |
3 months after surgery
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Postoperative joint function assessment
Délai: 3 months after surgery
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Hip Outcome Score (HOS) (range 0%-100%; higher scores indicate better outcomes). |
3 months after surgery
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Postoperative joint function assessment
Délai: 3 months after surgery
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International Hip Outcome Tool 12-Item Questionnaire (iHOT-12), range 0-100, higher scores mean better hip function |
3 months after surgery
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Economic Evaluation - Pain Intensity
Délai: 14 days after surgery
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This study will conduct an economic evaluation from a healthcare sector and societal perspective. Pain intensity is assessed using the Visual Analog Scale (VAS), a unidimensional measure reported as scores on a 0-100 mm scale. Effectiveness analysis will incorporate this clinical outcome. Safety will be evaluated by monitoring the incidence of adverse events within 3 months postoperatively. |
14 days after surgery
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Economic Evaluation - Hip Function
Délai: 14 days after surgery
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This study will conduct an economic evaluation from a healthcare sector and societal perspective. Hip function is assessed using the modified Harris Hip Score (mHHS), a measure specifically for hip dysfunction and related symptoms, reported as scores on a 0-100 scale. Effectiveness analysis will incorporate this clinical outcome. Safety will be evaluated by monitoring the incidence of adverse events within 3 months postoperatively. |
14 days after surgery
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Mean Total Healthcare Cost per Patient within 14 Days Postoperatively
Délai: Data collection period: From randomization until 14 days postoperatively.
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This is the cost input measure for the economic evaluation, adopting a healthcare system perspective. All direct medical costs related to the surgery and subsequent care from the day of surgery until 14 days postoperatively will be collected via the Hospital Information System. Costs include fees for surgery, anesthesia, medical supplies, hospitalization, medication, imaging and laboratory tests, and additional costs for managing complications. The mean total cost per patient (in Chinese Yuan, CNY) will be calculated separately for the "conventional perineal-post traction group" and the "perineal-post-free traction group". |
Data collection period: From randomization until 14 days postoperatively.
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Collaborateurs et enquêteurs
Parrainer
Parrainer
Les enquêteurs
Les enquêteurs
- Chercheur principal: chunbao li, MD, Chinese PLA General Hospital
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Début de l'étude
Achèvement primaire (Réel)
Achèvement primaire
Achèvement de l'étude (Estimé)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- 2024KY0158-KS001
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Individual participant data (IPD) will not be shared with external independent researchers. The original informed consent only permits internal study team, institutional ethics committee and regulatory authorities to access coded data for trial quality control, without explicit participant consent for sharing de-identified IPD for external secondary research. Full trial protocol, statistical analysis plan and analytic codes are available to eligible researchers for result replication upon reasonable request.
Informations sur les médicaments et les dispositifs, documents d'étude
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