MOVE-HIP: Ceramic Hip Resurfacing Versus Total Hip Arthroplasty Using Activity Monitoring (MOVE-HIP)

Participants undergo cementless ceramic-on-ceramic hip resurfacing arthroplasty using the selected study system according to manufacturer instructions, surgeon training requirements, and local surgical routines.

Cementless ceramic-on-ceramic hip resurfacing arthroplasty. The currently planned study implant is H1, or a subsequent equivalent generation if applicable. Procedures are performed by surgeons with documented arthroplasty experience and system-specific training.

• H1 ceramic hip resurfacing

Participants undergo contemporary standard primary total hip arthroplasty using established implants and bearing combinations according to local routine and individual clinical assessment. Cementless fixation is expected in most cases where clinically appropriate.

Contemporary standard primary total hip arthroplasty using established implants and bearing combinations according to local routine and individual clinical assessment. Implant choice remains clinically appropriate for the individual participant.

Mean daily walking distance is assessed during standardized 7-day wearable monitoring periods at each postoperative time point. The primary estimand is the adjusted overall between-group difference in mean daily walking distance across 3, 12, and 24 months, with adjustment for preoperative walking distance and prespecified covariates.

Mean daily walking distance derived from a standardized 7-day wearable monitoring period at 24 months.

Mean daily step count derived from standardized 7-day wearable monitoring periods at 3, 12, and 24 months.

Joint awareness assessed using the Forgotten Joint Score-12 (FJS-12). Scores range from 0 to 100, with higher scores indicating less awareness of the operated joint during everyday activities and a better outcome.

Proportion of participants achieving a Forgotten Joint Score-12 (FJS-12) of at least 80. The scale ranges from 0 to 100, with higher scores indicating less awareness of the operated joint during everyday activities and a better outcome.

HOOS Pain, Symptoms, Activities of Daily Living, Sport/Recreation, and Quality of Life subscales at 24 months. Each subscale ranges from 0 to 100, with higher scores indicating better status.

Self-reported habitual physical activity level assessed using the University of California, Los Angeles (UCLA) Activity Score. Scores range from 1 to 10, with higher scores indicating a higher level of physical activity and a better activity-related outcome.

Self-reported functional ability assessed using the High-Activity Arthroplasty Score (HAAS), covering walking, running, stair climbing, and activity level. Total scores range from 0 to 18, with higher scores indicating greater functional ability and a better outcome.

Health-related quality of life assessed using the EQ-5D-5L questionnaire. Responses are converted into an index using the Swedish experience-based time trade-off value set (Burström et al., 2020). Index values range from approximately 0.243 to 0.975, with higher values indicating better health-related quality of life.

Self-rated overall health assessed using the EuroQol Visual Analogue Scale (EQ VAS). Scores range from 0 (the worst health imaginable) to 100 (the best health imaginable), with higher scores indicating better perceived health.

Radiographic assessment includes component orientation and fixation, radiolucent lines, migration or loosening, heterotopic ossification, leg length and offset where feasible. In the hip resurfacing group, femoral neck integrity, notching, narrowing, fracture, femoral head movement or crushing, and component alignment are additionally assessed.

Incidence and type of adverse events and complications, including infection, dislocation, periprosthetic fracture, femoral neck fracture, implant fracture, thromboembolic events, nerve injury, wound complications, persistent pain, and other procedure- or implant-related events.

Number and proportion of participants undergoing reoperation or revision of the index hip, including reason and components exchanged or removed.

Quality-adjusted life years derived from EQ-5D and incremental cost-effectiveness comparing ceramic hip resurfacing with total hip arthroplasty over 24 months, using available direct and indirect cost data.

Revision-free implant survival assessed using study follow-up and registry data at 5 and 10 years.