Immediate unrestricted versus graduated weight bearing following primary cementless total hip arthroplasty: a randomized controlled trial

2017 ◽  
Vol 2 ◽  
pp. 6-6
Author(s):  
Magdy Shabana ◽  
Mahmoud A. Hafez ◽  
Khaled Ayad ◽  
Mohamed Abd Elfatah ◽  
Lilian Albert Zaky
Keyword(s):  
Randomized Controlled Trial ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Randomized Controlled

Virtual reality training improves trainee performance in total hip arthroplasty: a randomized controlled trial

2019 ◽  
Vol 101-B (12) ◽  
pp. 1585-1592 ◽  
Author(s):  
Kartik Logishetty ◽  
Branavan Rudran ◽  
Justin P. Cobb
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Controlled Trial ◽  
Total Hip ◽  
Randomized Controlled ◽  
Surgical Trainees ◽  
Vr Training ◽  
Component Orientation

Aims Arthroplasty skills need to be acquired safely during training, yet operative experience is increasingly hard to acquire by trainees. Virtual reality (VR) training using headsets and motion-tracked controllers can simulate complex open procedures in a fully immersive operating theatre. The present study aimed to determine if trainees trained using VR perform better than those using conventional preparation for performing total hip arthroplasty (THA). Patients and Methods A total of 24 surgical trainees (seven female, 17 male; mean age 29 years (28 to 31)) volunteered to participate in this observer-blinded 1:1 randomized controlled trial. They had no prior experience of anterior approach THA. Of these 24 trainees, 12 completed a six-week VR training programme in a simulation laboratory, while the other 12 received only conventional preparatory materials for learning THA. All trainees then performed a cadaveric THA, assessed independently by two hip surgeons. The primary outcome was technical and non-technical surgical performance measured by a THA-specific procedure-based assessment (PBA). Secondary outcomes were step completion measured by a task-specific checklist, error in acetabular component orientation, and procedure duration. Results VR-trained surgeons performed at a higher level than controls, with a median PBA of Level 3a (procedure performed with minimal guidance or intervention) versus Level 2a (guidance required for most/all of the procedure or part performed). VR-trained surgeons completed 33% more key steps than controls (mean 22 (sd 3) vs 12 (sd 3)), were 12° more accurate in component orientation (mean error 4° (sd 6°) vs 16° (sd 17°)), and were 18% faster (mean 42 minutes (sd 7) vs 51 minutes (sd 9)). Conclusion Procedural knowledge and psychomotor skills for THA learned in VR were transferred to cadaveric performance. Basic preparatory materials had limited value for trainees learning a new technique. VR training advanced trainees further up the learning curve, enabling highly precise component orientation and more efficient surgery. VR could augment traditional surgical training to improve how surgeons learn complex open procedures. Cite this article: Bone Joint J 2019;101-B:1585–1592

PERIOPERATIVE EXERCISE IMPROVES FUNCTION FOLLOWING TOTAL HIP ARTHROPLASTY: A RANDOMIZED CONTROLLED TRIAL

2003 ◽  
Vol 07 (02) ◽  
pp. 111-123 ◽  
Author(s):  
Helen J. Gilbey ◽  
Timothy R. Ackland ◽  
Jeff Tapper ◽  
Allan W. Wang
Keyword(s):  
Randomized Controlled Trial ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Controlled Trial ◽  
Exercise Group ◽  
Harris Hip Score ◽  
Exercise Programs ◽  
Total Hip ◽  
Randomized Controlled ◽  
Post Surgery

Until recently, limited evidence existed to support the efficacy of exercise programs for patients scheduled for total hip arthroplasty (THA), and no evidence-based guidelines were available regarding the length or intensity of exercise programs and their effect on patient recovery. The purpose of this randomized controlled trial was to determine the impact of an eight-week pre-surgery and 20 week post-surgery customized exercise program on the strength and function of subjects scheduled for THA. A series of physical tests and quality of life questionnaires were completed by patients (n = 57) pre-surgery and on three occasions post-surgery. In the week prior to surgery, the exercise group exhibited significant improvements (p < 0.05) in composite hip strength score and WOMAC total score in comparison to control subjects. By week 24, post-surgery scores for WOMAC total score, Harris Hip score, composite strength score, hip flexion range of motion of the operated hip and the distance walked in 6 minutes were significantly (p < 0.05) better in exercise group patients. A detailed description of the exercise intervention is presented in this paper.

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