Modeling and Workflow Recognition for the Anterior Approach in Total Hip Arthroplasty
NCT ID: NCT05993845
Last Updated: 2025-01-23
Study Results
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Basic Information
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RECRUITING
60 participants
OBSERVATIONAL
2024-10-30
2025-12-30
Brief Summary
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Detailed Description
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In Total Hip Arthroplasty (THA), a degenerated hip joint is replaced with an artificial acetabular and femoral component. In clinical practice, several approaches to accessing bone anatomy are employed. The direct anterior approach (DAA) has been adopted widely in recent years due to smaller incisions, fewer complications, faster recovery, and improved patient outcomes. However, the reduced space and limited access may cause more complexity in the execution of surgical steps.
Primary objective
The first goal of this project is to create a systematic and general description of the surgical process for DAA in THA. For this purpose, surgical process models (SPMs) provide a basis to manage, organize, and optimize the surgical process. For this purpose, a labeled dataset of THA surgery videos will be segmented into individual surgical steps and sub-steps using a systematic approach. SPMs are a simplified network of surgical or surgery-related activities and their relationships. These models can be used to compare several interventions, surgeons, or whole Operating Room teams. In addition, the SPMs can be used as input for workflow management systems.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Project population for total hip arthroplasty surgery recordings
We plan to record 60 total hip arthroplasty (THA) surgeries in the operating theatre performed by different surgeons of the hip team at Balgrist University Hospital or Kantonsspital Baden or Kantonsspital Winterthur, for data collection purposes.
Recording of total hip arthroplasty
We record total hip arthroplasties (THA) of hip surgeons at Balgrist University Hospital (BUH), Kantonsspital Baden (KSB), Kantonsspital Winterthur (KSW). Video \& audio data are stored locally at Balgrist-managed servers (patient-sensitive information removed).
Data includes:
Demographics (year of birth, sex, smoking status, body mass index) Diagnosis Surgery-specific data \& other surgical procedures during recording Standard preoperative Computed tomography of the hip/pelvis Standard pelvis x-rays pre- \& postoperative Standard axial hip x-rays pre- \& postoperative Western Ontario \& McMaster Universities Osteoarthritis Index \& Harris-Hip-Score To ensure the generated Surgical process model(SPM), evaluated using the recordings obtained from surgeries performed at BUH, generally describes the surgical process of THA, we apply our model to surgeries from the KSB and the KSW. There, 3 THAs are recorded and analyzed regarding commonalities and discrepancies in the SPM.
Interventions
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Recording of total hip arthroplasty
We record total hip arthroplasties (THA) of hip surgeons at Balgrist University Hospital (BUH), Kantonsspital Baden (KSB), Kantonsspital Winterthur (KSW). Video \& audio data are stored locally at Balgrist-managed servers (patient-sensitive information removed).
Data includes:
Demographics (year of birth, sex, smoking status, body mass index) Diagnosis Surgery-specific data \& other surgical procedures during recording Standard preoperative Computed tomography of the hip/pelvis Standard pelvis x-rays pre- \& postoperative Standard axial hip x-rays pre- \& postoperative Western Ontario \& McMaster Universities Osteoarthritis Index \& Harris-Hip-Score To ensure the generated Surgical process model(SPM), evaluated using the recordings obtained from surgeries performed at BUH, generally describes the surgical process of THA, we apply our model to surgeries from the KSB and the KSW. There, 3 THAs are recorded and analyzed regarding commonalities and discrepancies in the SPM.
Eligibility Criteria
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Inclusion Criteria
* Complete radiological data (CT and Hip/Pelvis x-ray)
* Signed consent
Exclusion Criteria
* Previous surgery of the hip at the site of the THA
* Fracture of the hip or pelvis at the site of the THA
18 Years
ALL
No
Sponsors
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Philipp Fürnstahl
OTHER
Kantonsspital Baden
OTHER
Kantonsspital Winterthur KSW
OTHER
Responsible Party
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Philipp Fürnstahl
Prof. Dr. Sc., Assistant Professor in Orthopedic Computer Science
Principal Investigators
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Philipp Fürnstahl, PhD
Role: PRINCIPAL_INVESTIGATOR
Balgrist University Hospital
Patrick Zingg, MD
Role: STUDY_CHAIR
Balgrist University Hospital
Locations
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Kantonsspital Baden
Baden, Canton of Aargau, Switzerland
Kantonsspital Winterthur
Winterthur, Canton of Zurich, Switzerland
Balgrist University Hospital
Zurich, Canton of Zurich, Switzerland
Countries
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Central Contacts
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Facility Contacts
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References
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Carrillo F, Esfandiari H, Muller S, von Atzigen M, Massalimova A, Suter D, Laux CJ, Spirig JM, Farshad M, Furnstahl P. Surgical Process Modeling for Open Spinal Surgeries. Front Surg. 2022 Jan 25;8:776945. doi: 10.3389/fsurg.2021.776945. eCollection 2021.
Charney M, Paxton EW, Stradiotto R, Lee JJ, Hinman AD, Sheth DS, Prentice HA. A Comparison of Risk of Dislocation and Cause-Specific Revision Between Direct Anterior and Posterior Approach Following Elective Cementless Total Hip Arthroplasty. J Arthroplasty. 2020 Jun;35(6):1651-1657. doi: 10.1016/j.arth.2020.01.033. Epub 2020 Jan 22.
Haynes JA, Hopper RH Jr, Ho H, McDonald JF 3rd, Parks NL, Hamilton WG. Direct Anterior Approach for Primary Total Hip Arthroplasty Lowers the Risk of Dislocation Compared to the Posterior Approach: A Single Institution Experience. J Arthroplasty. 2022 Mar;37(3):495-500. doi: 10.1016/j.arth.2021.11.011. Epub 2021 Nov 10.
Neumuth T, Jannin P, Strauss G, Meixensberger J, Burgert O. Validation of knowledge acquisition for surgical process models. J Am Med Inform Assoc. 2009 Jan-Feb;16(1):72-80. doi: 10.1197/jamia.M2748. Epub 2008 Oct 24.
Patel NN, Shah JA, Erens GA. Current Trends in Clinical Practice for the Direct Anterior Approach Total Hip Arthroplasty. J Arthroplasty. 2019 Sep;34(9):1987-1993.e3. doi: 10.1016/j.arth.2019.04.025. Epub 2019 Apr 18.
Seibold, M., Hoch, A., Farshad, M., Navab, N., & Fürnstahl, P. (2022). Conditional generative data augmentation for clinical audio datasets. Medical Image Computing and Computer Assisted Intervention (MICCAI). Singapore.
Zisimopoulos, O., Flouty, E., Luengo, I., Giataganas, P., Nehme, J., Chow, A., & Stoyanov, D. (2018). DeepPhase: Surgical Phase Recognition in CATARACTS Videos. Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial, 11073, 265-275.
Other Identifiers
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W1018
Identifier Type: -
Identifier Source: org_study_id
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