Comparison of clinical outcome with or without retention of the joint capsule in total hip arthroplasty for treatment of end-stage arthritis
End-stage osteoarthritis of the hip joint
Radiographic examinations of the hip joint will be performed according to the standard procedures for total hip arthroplasty (conventional ap pelvis view and hip cross-table lateral view for pre-operative diagnosis and planning and postoperative evaluation of implant positioning and stability). During standard total hip replacement via the direct anterior approach, the hip joint capsule is incised to access the joint. Feasibility of preservation of the anterior capsule is assessed upon closure. In the study group the anterior capsule will be preserved and reattached, in the control group the anterior capsule will be excised and discharged. Group assignment is not made until the very last moment before closure to ensure that the selection does not affect the main surgery (THA). To avoid observer bias, the person performing the physical testing is unaware of the surgical method.
1. End-stage primary osteoarthritis 2. Age 18 years and older 3. Indication for total hip arthroplasty 4. Direct anterior approach 5. Use of standard implants
1. Secondary causes of osteoarthritis (e.g. fracture, dysplasia, deformities etc) 2. Prior surgery to the hip joint 3. Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. 4. Patients with mental disorders or medical conditions with disturbance of balance, rendering them unable to participate in the physical tests 5. Lack of written consent or refusal to participate 6. Pregnant or lactating women 7. Use of revision implants 8. Contraindications for the use of direct anterior approach (severe obesity, infections or injury to the skin anterior to the hip) 9. Contralateral total hip arthroplasty within the last 12 months 10. Hip joint capsule that cannot be retained for medical or technical reasons until after final positioning of the implants