Kan fri perineal post-traction vid höftartroskopi effektivt minska perineala komplikationer?
Kan perinealstångsfri traktion vid höftartroskopi effektivt minska perineala komplikationer? En multicentrisk prospektiv randomiserad kontrollerad studie
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
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
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Beijing Municipality
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Beijing, Beijing Municipality, Kina, 100143
- Chinese PLA General Hospital
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-
Guangdong
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Shenzhen, Guangdong, Kina, 518035
- Shenzhen Second People's Hospital
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-
Henan
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Luoyang, Henan, Kina, 471002
- Luoyang Orthopedic Traumatological Hospital of Henan
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-
Jiangsu
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Nanjing, Jiangsu, Kina, 210008
- The Affiliated Drum Tower Hospital, Medical School of Nanjing University
-
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Shaanxi
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Xi'an, Shaanxi, Kina, 710038
- The Second Affiliated Hospital of Air Force Medical University (AFMU)
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Shandong
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Tai’an, Shandong, Kina, 271000
- The Second Affiliated Hospital of Shandong First Medical University
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Kina, 200080
- Shanghai General Hospital
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Sichuan
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Chengdu, Sichuan, Kina, 610041
- West China Hospital, Sichuan University
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Yunnan
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Kunming, Yunnan, Kina, 650032
- The First Affiliated Hospital of Kunming Medical University
-
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Zhejiang
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Hangzhou, Zhejiang, Kina, 310006
- Zhejiang Provincial Hospital of Chinese Medicine
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-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Dubbel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Perineal Post-Fri Traktion
|
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. |
|
Aktiv komparator: Perineal Post Traktion
|
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. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
The incidence of perineal nerve injury
Tidsram: The first day after surgery
|
The incidence of perineal nerve injury included: perineal numbness, pain, soft tissue injury, sexual function and urinary dysfunction. |
The first day after surgery
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
The incidence of pain, numbness, soft tissue injury in other places
Tidsram: The first day after surgery
|
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
|
|
Patients at discharge perineum area incidence of nerve injury
Tidsram: 7 days after surgery
|
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
|
|
Intraoperative traction time
Tidsram: During surgery (intraoperatively)
|
Intraoperative traction time |
During surgery (intraoperatively)
|
|
Preoperative preparation time
Tidsram: Immediately before surgery (preoperatively)
|
Preoperative preparation time |
Immediately before surgery (preoperatively)
|
|
Operating time
Tidsram: During surgery (intraoperatively)
|
Operating time |
During surgery (intraoperatively)
|
|
The average length of hospital stay after surgery
Tidsram: 6 weeks after surgery
|
The average length of hospital stay after surgery |
6 weeks after surgery
|
|
Postoperative joint function assessment
Tidsram: 3 months after surgery
|
Visual Analog Scale (VAS) (range 0-10; higher scores indicate worse outcomes). |
3 months after surgery
|
|
Postoperative joint function assessment
Tidsram: 3 months after surgery
|
Modified Harris Hip Score (mHHS) (range 0-100; higher scores indicate better outcomes). |
3 months after surgery
|
|
Postoperative joint function assessment
Tidsram: 3 months after surgery
|
Hip Outcome Score (HOS) (range 0%-100%; higher scores indicate better outcomes). |
3 months after surgery
|
|
Postoperative joint function assessment
Tidsram: 3 months after surgery
|
International Hip Outcome Tool 12-Item Questionnaire (iHOT-12), range 0-100, higher scores mean better hip function |
3 months after surgery
|
|
Economic Evaluation - Pain Intensity
Tidsram: 14 days after surgery
|
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
|
|
Economic Evaluation - Hip Function
Tidsram: 14 days after surgery
|
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
|
|
Mean Total Healthcare Cost per Patient within 14 Days Postoperatively
Tidsram: Data collection period: From randomization until 14 days postoperatively.
|
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.
|
Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: chunbao li, MD, Chinese PLA General Hospital
Publikationer och användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- 2024KY0158-KS001
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
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.
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