Imaging Techniques for Hip Surgery Assessment
Recruiting in Palo Alto (17 mi)
Overseen byDavid MacLeod
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Duke University
Disqualifiers: Revision hip, Ipsilateral knee, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Objective measures of skeletal muscle features have previously been used to assess skeletal muscle quality. In certain clinical populations, such as intensive care (ICU) patients, specific features of the psoas muscle measured by abdominal CT have been used to assess the nutritional status of the patient. Abdominal CT is not performed routinely as it exposes the patient to ionizing radiation (X-rays) and can only be performed intermittently.
The measurement of the thigh muscles (rectus femoris muscle, part of the quadriceps muscle) by handheld musculoskeletal (MSK) ultrasound is a simple, safe (no ionizing radiation) and repeatable (can be easily performed on a daily basis) technique. A correlation has been shown between muscle parameters of the psoas muscle (abdominal CT) and the rectus femoris muscle (MSK). A direct comparison between muscle parameters of the same skeletal muscle measured with both CT and MSK has not been done.
Intramuscular adipose tissue (IMAT) is a measure of the extent of adipose tissue deposited within the muscle. It is a biomarker of muscle quality. The study objective is to compare muscle area and intramuscular adipose tissue (IMAT) content of rectus femoris muscle, measured by standard CT imaging with point of care handheld musculoskeletal (MSK) ultrasound in patients presenting for primary total hip arthroplasty. This patient group is chosen because they will have hip CT performed as standard of care prior to surgery.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of this treatment for hip surgery assessment?
Ultrasound is highlighted as a useful tool for evaluating hip issues because it is accessible, does not involve radiation, and can assess both sides of the hip and guide procedures. It is particularly effective in assessing hip pain and instability, and can be adapted for different body types to ensure accurate imaging.
12345Is imaging for hip surgery assessment safe?
CT scans, including low-dose and ultra-low-dose versions, are generally considered safe for hip imaging, with radiation exposure similar to conventional methods. Ultrasound imaging is also used safely for assessing hip displacement, especially in children.
678910How does the imaging treatment for hip surgery assessment differ from other treatments?
The imaging treatment using CT and ultrasound for hip surgery assessment is unique because it provides detailed three-dimensional views and visualizes soft tissues and cartilage, which helps in diagnosing hip conditions, planning surgeries, and evaluating postoperative results. This approach is more advanced compared to traditional X-rays, which primarily show bone structures.
1112131415Eligibility Criteria
This trial is for patients scheduled for primary hip replacement surgery. It aims to compare muscle quality assessments using two different imaging techniques: CT scans and handheld ultrasound.Inclusion Criteria
I have had a hip replacement surgery.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Imaging
Participants undergo both CT and MSK ultrasound imaging to measure intramuscular adipose tissue (IMAT) and muscle area
1 hour
1 visit (in-person)
Follow-up
Participants are monitored for safety and effectiveness after imaging procedures
4 weeks
Participant Groups
The study is testing the effectiveness of musculoskeletal (MSK) ultrasound against standard CT imaging in measuring muscle area and fat within muscles (IMAT) in the thigh, specifically in patients undergoing hip arthroplasty.
2Treatment groups
Experimental Treatment
Active Control
Group I: UltrasoundExperimental Treatment1 Intervention
Patients have ultrasound scans together with standard of care CT prior to primary hip replacement
Group II: CTActive Control1 Intervention
Patients have standard of care CT prior to primary hip replacement
CT is already approved in European Union, United States, Canada, Japan, China, Switzerland for the following indications:
🇪🇺 Approved in European Union as Computed Tomography for:
- Diagnostic imaging for various medical conditions
🇺🇸 Approved in United States as Computed Tomography for:
- Diagnostic imaging for various medical conditions
🇨🇦 Approved in Canada as Computed Tomography for:
- Diagnostic imaging for various medical conditions
🇯🇵 Approved in Japan as Computed Tomography for:
- Diagnostic imaging for various medical conditions
🇨🇳 Approved in China as Computed Tomography for:
- Diagnostic imaging for various medical conditions
🇨🇭 Approved in Switzerland as Computed Tomography for:
- Diagnostic imaging for various medical conditions
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Duke University Medical CenterDurham, NC
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Who Is Running the Clinical Trial?
Duke UniversityLead Sponsor
References
High-resolution ultrasound in the evaluation of the adult hip. [2023]This paper reviews ultrasound of the hip, which is a commonly requested examination for symptomatic hip issues. This includes both intra-articular and extra-articular causes of hip pain. Ultrasound is easily accessible, lacks radiation exposure, and allows for evaluation of the contralateral hip as well as assessment of dynamic maneuvers. Ultrasound can be used to guide interventional procedures. Ultrasound of the hip can be challenging due to the deep location of structures and complex anatomy. Typically, high-frequency transducers are used to examine the hip, however the choice of ultrasound transducer depends on the patient's body habitus, with lower frequency transducers required to penetrate deep structures in obese patients. It is important to have an approach to ultrasound of the hip which includes assessment of the anterior, lateral, posterior, and medial aspects of the hip. The technique and relevant anatomy of each of these compartments are discussed as well as the use of Doppler examination of the hip. Several dynamic maneuvers can be performed to help determine the cause of hip pathology in various locations, and these are described and illustrated. Ultrasound is useful for guided procedures about the hip, and these indications will be reviewed.
Clinical value of digital tomographic fusion imaging in the diagnosis of avascular necrosis of the femoral head in adults. [2022]To explore the clinical significance of digital tomographic fusion imaging in the diagnosis of avascular disease of the femoral head in adults.
Legg-Calvé-Perthes disease: multipositional power Doppler sonography of the proximal femoral vascularity. [2021]Selection of the most appropriate sonographic scanning approaches for evaluation of hips can improve the method efficacy and decrease the scanning time.
Vibroacoustography for the assessment of total hip arthroplasty. [2022]This paper proposes imaging with 3-dimensional vibroacoustography for postoperatively assessing the uncovered cup area after total hip arthroplasty as a quantitative criterion to evaluate implant fixation.
Dynamic ultrasound assessment of hip instability and anterior and posterior hip impingement. [2023]In this technical report, we describe our protocol for the dynamic sonographic evaluation of the hip and assess reliability of the ultrasound assessment of hip microinstability.
Postoperative Musculoskeletal Imaging and Interventions Following Hip Preservation Surgery, Deformity Correction, and Hip Arthroplasty. [2022]Total hip arthroplasty and hip preservation surgeries have substantially increased over the past few decades. Musculoskeletal imaging and interventions are cornerstones of comprehensive postoperative care and surveillance in patients undergoing established and more recently introduced hip surgeries. Hence the radiologist's role continues to evolve and expand. A strong understanding of hip joint anatomy and biomechanics, surgical procedures, expected normal postoperative imaging appearances, and postoperative complications ensures accurate imaging interpretation, intervention, and optimal patient care. This article presents surgical principles and procedural details pertinent to postoperative imaging evaluation strategies after common hip surgeries, such as radiography, ultrasonography, computed tomography, and magnetic resonance imaging. We review and illustrate the expected postoperative imaging appearances and complications following chondrolabral repair, acetabuloplasty, osteochondroplasty, periacetabular osteotomy, realigning and derotational femoral osteotomies, and hip arthroplasty.
Ultrasound Imaging of Hip Displacement in Children With Cerebral Palsy. [2023]An approach to estimation of hip displacement on ultrasound (US) images is described. Its accuracy is validated through numerical simulation, an in vitro study with 3-D-printed hip phantoms and pilot in vivo data.
Ultra-low-dose CT versus radiographs for minor spine and pelvis trauma: a Bayesian analysis of accuracy. [2021]To compare diagnosis performance and effective dose of ultra-low-dose CT (ULD CT) versus radiographs in suspected spinal or pelvic ring or hip fracture for minor trauma.
Radiation exposure and image quality in computed tomography for hip joint measurements in children. [2016]Computed tomography (CT) is considered a useful modality in the diagnosis of hip abnormalities in children. In this article a procedure is described, using low dose CT with thick slices and integration of different images, in which radiation exposure is in ranges equal to the conventional methods. This makes CT the method of choice for routine examination.
Ultralow-Dose CT (REDUCTION Protocol) for Extremity Fracture Evaluation Is as Safe and Effective as Conventional CT: An Evaluation of Quality Outcomes. [2019]To assess clinical and hospital quality outcomes of patients receiving the previously reported Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury (REDUCTION) imaging protocol.
[Imaging of the hip]. [2016]Imaging is fundamental to the diagnosis and therapeutic follow-up of all hip diseases. Despite the advent of extremely sophisticated exploratory methods, the oldest imaging method, straightforward radiography, makes it possible to recognize, locate ans treat the lesion in most cases. Good interpretation of simple antero-posterior and lateral x-ray films therefore is very important. Among the new imaging methods, computerized tomography has brought the third dimension, while ultrasonography and nuclear magnetic resonance have enabled us to visualize cartilages and soft tissues. The contribution to diagnosis and follow-up of these modern methods is considerable, but since we are too near their beginning and since the number of examinations is still too small in many fields, the information they provide must be used with caution. A good knowledge of their principle, advantages and drawbacks should help us to utilize them at best by prescribing only those which are necessary and sufficient for diagnosis and treatment.
Imaging of the pelvis and hip. [2016]Imaging is basic in the orthopedic evaluation of hip disorders. For optimal evaluation of these images, the orthopedic surgeon must not only correlate normal anatomy and pathology with radiographic findings, but must also be familiar with the newer modalities of CT, magnetic resonance imaging and ultrasound and the role and place of these studies in the evaluation of musculoskeletal disorders. This article correlates normal anatomy of the hip with these modalities and discusses the details of these techniques, particularly CT and MRI, that are pertinent to the orthopedic surgeon.
The application of advanced CT imaging and computer graphics methods to reconstructive surgery of the hip. [2022]Advanced computed tomographic and computer graphic techniques enhance diagnostic accuracy and offer the means by which three-dimensional operative planning can be achieved. These techniques have been used to diagnose hip pathology, rehearse and evaluate surgical plans, assess postoperative results, and design individualized prostheses.
Diseases of the musculoskeletal system in children: imaging with CT, sonography, and MR. [2016]We reviewed the applications of CT, sonography, and MR imaging in diseases of the musculoskeletal system in children. Unique advantages of each technique are discussed, and common disease entities and practical applications of the three imaging methods are stressed. Evaluation of congenital dysplasia of the hip, hip effusion, and soft-tissue foreign bodies with sonography are emphasized. The role of CT in imaging patients with congenital dysplasia of the hip, tarsal coalition, osteomyelitis, and benign and malignant bone tumors is stressed. Common applications of MR that are emphasized include imaging of osteomyelitis, musculoskeletal tumors, normal bone marrow, and avascular necrosis. Innovations are briefly discussed, including evaluation of dermatomyositis with MR and imaging sternoclavicular dislocation, congenital vertical talus, and fractures and dislocations with sonography.
[Imaging of hip joint arthroplasty]. [2021]The hip joint is the largest joint in the human body and consequently, its evaluation by diagnostic imaging is highly important. This includes imaging of hip joint arthroplasty, which is used to avoid joint immobility following a wide spectrum of diseases, such as end-stage degenerative disease, avascular necrosis of the femoral head or post-traumatic fractures. Conventional radiography is still the standard imaging modality for the evaluation of hip arthroplasty both directly following surgery and for periodical follow-up. In the majority of cases conventional radiography enables adequate assessment of early and late complications that can arise following hip arthroplasty, such as loosening, prosthetic or periprosthetic fracture, luxation, infection and soft tissue calcification. If the diagnosis cannot be established by means of radiography, advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), with or without injection of contrast media, may provide additional information. This is particularly true for the depiction of inflammatory processes. Regardless of the imaging modality used patients' clinical symptoms must also be taken into account in order to establish the correct diagnosis.