Comparing hip arthroscopy and total hip replacement for early hip osteoarthritis

Clinical and Cost-effectiveness of Hip Arthroscopy Versus Definitive Total Hip Arthroplasty in 40-60 Year Olds With Early Hip Osteoarthritis: A Randomized Trial

This study is testing whether hip arthroscopy or total hip replacement works better for people aged 40-60 with early hip osteoarthritis.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 160 (estimated)
• Ages: 40 Years to 60 Years
• Sex: All
• Sponsor: Western University, Canada (Academic / other)
• Locations: 2 sites (New Westminster, British Columbia and 1 other locations)
• Trial ID: NCT04166227 on ClinicalTrials.gov

What this trial studies

This study aims to compare the effectiveness of hip arthroscopy versus total hip arthroplasty (THA) in treating early hip osteoarthritis in patients aged 40-60. It is a randomized controlled trial that will assess the differences in patient outcomes using the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and evaluate the long-term cost-effectiveness of each intervention. The study will also identify predictors of outcomes following hip arthroscopy and estimate lifetime costs using a Markov model.

Who should consider this trial

Good fit: Ideal candidates for this study are individuals aged 40-60 with mild to moderate hip osteoarthritis who have not responded to at least three months of non-operative management.

Not a fit: Patients with advanced osteoarthritis or those with specific anatomical issues that preclude safe arthroscopic access will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide insights into the most effective treatment options for early hip osteoarthritis, potentially improving patient outcomes and reducing healthcare costs.

How similar studies have performed: Previous studies have explored similar interventions, but this specific comparison of hip arthroscopy versus THA for early-stage hip osteoarthritis is relatively novel.

Eligibility criteria

Inclusion criteria:

1. Between the ages of 40-60 years at the time of surgery.
2. Radiographic evidence of mild to moderate hip OA (Tönnis Gr 0 with MRI chondral wear, Tönnis Gr 1 and 2).
3. Patients must have completed ≥3 months of non-operative management with ongoing symptoms.

Exclusion criteria:

1. Advanced OA, defined as \<2 mm joint space (Tönnis Gr 3) or those with acetabular or femoral head cysts.
2. Patients who are pregnant or may become pregnant around the time of surgery.
3. Prior arthroplasty of the contralateral hip.
4. Current or prior hip dysplasia (defined by a lateral centre edge angle of \<20 degrees).
5. Acetabular protrusio or coxa profunda, making arthroscopic access unsafe/unfeasible.

Where this trial is running

New Westminster, British Columbia and 1 other locations

• Fraser Health — New Westminster, British Columbia, Canada (Recruiting)
• Fowler Kennedy Sport Medicine Clinic and University Hospital — London, Ontario, Canada (Recruiting)

Study contacts

• Principal investigator: Ryan Degen, MD, FRCSC — Fowler Kennedy Sport Medicine Clinic
• Study coordinator: Stacey Wanlin

Conditions Hip Osteoarthritis; Hip Scope; Total Hip Replacement