Minimising Limb-length inequality following total hip replacement.

  • Research type

    Research Study

  • Full title

    Minimising Limb-length inequality following total hip replacement; a proof of concept study to develop a device-assisted intraoperative assessment technique.

  • IRAS ID

    147512

  • Contact name

    Derek Norfolk

  • Contact email

    derek.norfolk@nhs.net

  • Sponsor organisation

    Leeds Teaching Hospitals NHS Trust

  • Duration of Study in the UK

    1 years, 1 months, 0 days

  • Research summary

    Leg length inequality (LLI) after total hip replacement (THR) is an increasingly prominent problem for both patient and surgeon. It can lead to complications such as dislocation, nerve damage and back pain and is now one of the top five reasons for litigation against orthopaedic surgeons in the UK and the number one cause in the USA . Whilst there are many well-known ways of minimising LLI, there is no optimum method with 100% success and reproducibility. One of the tests that a surgeon may utilise during THR is testing the tension of the muscles around the implanted hip. If the leg is too short then the hip will be unstable and dislocate too easily, if the leg is too long then the soft tissues around the hip will be tight and the surgeon will be unable to displace the implant head from the socket. This is called the shuck test. This study is based on developing a device to ensure the soft tissues are at the correct tension and indirectly test leg length. There will be two stages of research:
    1: Device development
    The shuck test will be performed on 30 patients with a ring-marked head to indicate how far it is pulled from the socket and whether it is exposed to a consistent degree. After establishing this we will conduct a larger observational trial of 120 patients, examining the force used by the surgeon during the shuck test.
    2: Device testing - proof of concept study.
    Having determined the procedure for using the device we will conduct a small trial of 15 patients to assess the performance of the finalized device when used in this standardised manner.
    The overall aim of the study is to develop a device that gives the same results as an experienced orthopaedic surgeon when assessing leg length during THR.

  • REC name

    Yorkshire & The Humber - South Yorkshire Research Ethics Committee

  • REC reference

    15/YH/0081

  • Date of REC Opinion

    5 Mar 2015

  • REC opinion

    Unfavourable Opinion