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Trial registered on ANZCTR
Registration number
ACTRN12615000796583
Ethics application status
Approved
Date submitted
13/07/2015
Date registered
31/07/2015
Date last updated
31/07/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluation of anatomical head center, gait and bone re-modelling after Total hip replacement – Randomized controlled trial of neck preserving versus conventional hip prosthesis
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Scientific title
A Single Centre, Participant-Blinded, Randomized, 12 Month, Parallel Group, Trial Of The Anatomical Head Center, Gait And Bone Remodelling After Total Hip Replacement Using Cementless Neck Preserving Versus Conventional Hip Prosthesis
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Secondary ID [1]
287068
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nil
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Universal Trial Number (UTN)
U1111-1172-0486
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Osteoarthritis
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Total Hip Replacement
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Condition category
Condition code
Musculoskeletal
295834
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0
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Osteoarthritis
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Surgery
295947
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention involves the surgical replacement of the hip joint performed by an orthopaedic surgeon using the Minihip Stem (Corin Ltd) hip prosthesis. This stem is designed as a femoral neck preserving, short prosthesis with the philosophy of bone preservation in the proximal area (metaphysis) of the femur.
Surgical approach will be via the direct anterior approach. Approximate duration of the surgical procedure is 60-90 minutes.
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Intervention code [1]
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Treatment: Devices
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Intervention code [2]
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Treatment: Surgery
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Comparator / control treatment
The control intervention involves the surgical replacement of the hip joint performed by an orthopaedic surgeon using the Metafix Stem (Corin Ltd) hip prosthesis. This stem is a conventional hip stem prosthesis, that does not preserve the femoral neck. Conventional hip stems are the most commonly utilised femoral prostheses and are standard of care.
Surgical approach will be via the direct anterior approach. Approximate duration of the surgical procedure is 60-90 minutes.
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Control group
Active
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Outcomes
Primary outcome [1]
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Anatomical Centre of Rotation defined by Horizontal Femoral Offset (mm), Horizontal Centre of Rotation (mm), Vertical Centre of Rotation (mm), Vertical Femoral Offset (mm), and Anteversion (degrees), leg length will be measured using plain radiographs (A-P and modified Budin views)
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Assessment method [1]
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Timepoint [1]
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Pre-Operative and 3 months post operative
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Secondary outcome [1]
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Bone Density (T Score) using DEXA scan of the femur
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Assessment method [1]
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Timepoint [1]
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Immediate Post Operative and 1 year
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Secondary outcome [2]
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Gait Analysis; velocity (m/s), cadence (m), step length (m), gait cycle duration (seconds), stance phase duration (seconds), swing phase duration (seconds), double and single support duration (seconds). Data for gait analysis will be acquired using the BTS G-Walk (patient wearable device) and managed through the compatible software, BTS G-Studio Software.
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Assessment method [2]
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Timepoint [2]
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Pre Operative, 3 months, 1 year, 2 years and 5 years
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Secondary outcome [3]
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Quality of life assessed through patient-reported health survey; the Short Form (36) Health Survey (SF36)
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Assessment method [3]
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Timepoint [3]
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Pre Operative, 3 months, 1 year, 2 years and 5 years
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Secondary outcome [4]
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Quality of life assessed through patient-reported health survey; the Oxford Hip Score (OHS).
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Assessment method [4]
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Timepoint [4]
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Pre Operative, 3 months, 1 year, 2 years and 5 years
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Eligibility
Key inclusion criteria
1. Eligible for a primary total hip replacement
2. Dorr type A femur
3. Willing to comply with the protocol
4. Willing and competent to consent
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Minimum age
30
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Not meeting the inclusion criteria
2. Any patient with a revision / resurfacing or a hemi hip replacement
3. Patients with a Dorr type B or C femur
4. Cemented hip replacement
5. Medically Unfit for surgery
6. Not willing to comply with the protocol
7. Not willing or competent to consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be randomly assigned to either group with a 1:1 allocation as per a computer generated randomization schedule by using permuted blocks of random sizes. The block sizes will not be disclosed, to ensure concealment. Participants will be randomized using the Interactive Voice response System provided by the NHMRC Clinical Trials Center, which is an online central randomization service. Allocation concealment will be ensured, as the service will not release the randomization code until just before the patient is going to be operated has been recruited into the trial, which takes place after all baseline measurements have been completed. The investigators will obtain this code just before the start of the surgery.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The allocation sequence will be generated by the IVRS by the NHMRC-CTC applying a permuted block design with random blocks stratified by age. The randomization list remains with them for the whole duration of the study. Thus, randomization will be conducted without any influence of the principal investigators.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Baseline patient demographic (age, sex, ethnicity, other) and clinical characteristics (height, weight, BMI, ROM, leg length) will be summarised for each study arm using means and SD, or medians and interquartile ranges for continuous variables and percentages for categorical variables.
Pilot data available for 20 patients has been used to conservatively estimate the difference in horizontal femoral offset (baseline - 3 month) between the groups is 7mm, with a standard deviation of 6. Based on this information, the sample size required for this study has been calculated as 32 patients (16 patients per group) to detect a statistically significant difference in the mean difference in the horizontal femoral offset at 3 months compared to baseline (primary outcome) between the study groups using the independent t-test. Taking into account the possibility of cross-overs from the NPP arm to standard arm and drop outs we have increased the sample size estimation to 20 patients per group.
This sample size will allow us to reject the null hypothesis that this response difference is zero with probability (power) 0.90. The Type I error probability associated with this test of this null hypothesis is 0.05.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/08/2015
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Actual
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Date of last participant enrolment
Anticipated
14/10/2015
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Norwest Private Hospital - Bella Vista
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Recruitment hospital [2]
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Macquarie University Hospital - Macquarie Park
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Recruitment hospital [3]
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Sydney Adventist Hospital - Wahroonga
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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CORIN (Australia) Pty Ltd
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Address [1]
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17 Bridge St
Pymble NSW 2073
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Country [1]
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
CORIN (Australia) Pty Ltd
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Address
17 Bridge St
Pymble NSW 2073
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Other collaborator category [1]
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Individual
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Name [1]
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Aditya Khemka
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Address [1]
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Munjed Al Muderis
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Address [2]
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Sally Lord
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Address [3]
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School of Medicine,
Sydney,
University of Notre Dame Australia
160 Oxford Street,
Darlinghurst, NSW, 2010
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Zelda Doyle
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Address [4]
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School of Medicine,
Sydney,
University of Notre Dame Australia
160 Oxford Street,
Darlinghurst, NSW, 2010
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Country [4]
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Australia
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Other collaborator category [5]
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Individual
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Name [5]
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Belinda Bosley
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Address [5]
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country [5]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The University of Notre Dame
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Ethics committee address [1]
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19 Mouat street Fremantle WA 6959
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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01/05/2015
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Approval date [1]
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09/07/2015
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Ethics approval number [1]
293158
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014160S
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Summary
Brief summary
This clinical study is a single centre, prospective, randomized, participant-blinded trial enrolling 40 patients to receive either a Cementless Neck Preserving stem or a Conventional Hip stem Prosthesis. Neck preserving prostheses to offer a more physiological load transmission across the femur, the nature of achieving a stable press-fit means that the stem must adapt to the geometry of the bone. As patient anatomy is highly variable, there is limited ability to adjust the femoral offset, centre of rotation, femoral anteversion and leg length. It is unclear whether anatomical restoration, offered by neck preserving prostheses is comparable to conventional prostheses. The success of the neck preserving systems relies on the precise positioning and sizing of the implant and the excellent long-term durability of the ceramic bearings. Hence, we propose a randomized comparative study to assess and compare the anatomical head centre, gait analysis and bone remodelling of two parallel groups receiving either a Neck preserving or a Conventional hip stem prosthesis by the direct anterior approach. Antero-posterior and modified Budin x-rays will be analysed at preoperatively, 3 months, 12 months, 2 years and 5 years to assess femoral head offset, stem orientation and leg length. DEXA (bone density) scans will be assessed pre-operatively and 12 months to measure femoral bone density, with the aim of assessing bone remodelling after total hip replacement. Spatial-Temporal gait analysis will be used to quantify measurement of standard gait (6 minute walking test – 6MWT) and sit-to-stand preoperatively, 3 months and 12 months. Standard, functional parameters will be assessed pre-operatively, 3 months, 12 months, 2 years and 5 years.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Munjed Al Muderis
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Address
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country
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Australia
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Phone
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1800-907-905
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Belinda Bosley
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Address
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country
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Australia
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Phone
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1800-907-905
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Aditya Khemka
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Address
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Norwest Advanced Orthopedics
Suite G 3 B, Norwest Private Hospital,
9 Norbik Drive, Bella Vista, NSW – 2153
Australia
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Country
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Australia
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Phone
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1800-907-905
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF