Clinical Trials

Total hip arthroplasty is a one of the most commonly performed surgical procedures with increasing numbers anticipated over the next several decades. Differences in the analgesia outcomes between these three intervention groups would provide for an evidenced-based clinical pathway that will emerge as a result of this study.

Hypothesis:

Patients undergoing total hip arthroplasty within a clinical pathway utilizing preemptive low-dose opioid and non-opioid medications for multimodal analgesia randomized to peripheral nerve blockade will report less pain with movement on an NRS scale POD #1 compared to randomization to periarticular injection with ropivacaine mixture or periarticular injection with liposomal bupivacaine (Exparel®).

Does having a large diameter metal on polyethylene total hip replacement increase metal ion release? Larger metal heads are thought to have increased torsional forces on the trunion which would like release more metal ions. Increased metal ion levels have been associated with adverse local tissue reactions. Are there any differences comparing these groups to a dual mobility type total hip replacement.

The primary objective of this study is to determine whether the functional cup orientation for dislocating hips differs from the functional cup orientation for asymptomatic non-dislocating hips.

The primary aim of the study is to compare the results of an established, successful procedure, which is total hip arthroplasty through a mini-posterior approach to a less studied - increasingly popular procedure, which is total hip replacement through the direct anterior approach utilizing the orthopedic table.

The purpose of this study is to assess daily living activity levels of patients before and after total hip replacement, and to correlate these activities of daily living to those usually obtained with disease-specific questionnaires.

The objectives of this study are to evaluate changes in pubic symphysis to sacrococcygeal junction distance (PSCD), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL) between three separate evaluations in preoperative candidates for Total Hip Arthroplasty (THA), and to evaluate changes in pubic symphysis to sacrococcygeal junction distance (PSCD), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL) between three separate evaluations in postoperative THA patients.

The purpose of this study is to obtain bone from up to 200 patients undergoing orthopedic procedures (including elective hip replacement or hip replacement following fracture) to perform these studies.  From these waste bone samples that would otherwise be discarded following review by pathology, we will isolate bone cells (osteoblasts, osteoclast, and osteocytes), protein, RNA, and DNA.  

Patients undergoing a total hip arthroplasty (THA) using either a direct anterior or posterolateral approach will be asked to return to clinic 2 years following THA to evaluate their scars from the incisions. Both the Patient Observer Scar Assessment Scale (POSAS) and the Stony Brook Scar Evaluation Scale (SBSES) will be used to assess patients’ scars. The results of these evaluation scales will then be compared between the anterior and posterolateral approach cohorts.

The purpose of this study is to collect 2 years of information regarding the performance of the commercially available Actis™ Total Hip replacement system in order to evaluate the clinical outcomes.

The purpose of this study is to determine the prevalence of groin pain after total hip arthroplasty (THA) with a dual-mobility cup, and to compare this rate of groin pain to patients who receive standard THA components.

The purpose of this study is to determine if modular dual mobility (MDM) hips are at risk of increased serum metal ion levels.

Does tranexamic acid improve the perioperative care of those patients treated surgically for hip fracture by decreasing the proportion of patients requiring transfusion and decreasing total perioperative bleeding?

You are being asked to take part in this research study because you are scheduled to have total hip replacement (arthroplasty) surgery. The goal of this study is to evaluate the effectiveness of the drug, epsilon Aminocaproic Acid (EACA), in decreasing the need for patients to receive blood after surgery. Currently, EACA is approved by the Federal Drug Administration (FDA) to treat a patient who is bleeding. The investigators plan to use EACA to prevent bleeding during and after surgery; use of this drug as a means of preventing bleeding is not currently approved by the FDA.

We plan to analyze patient satisfaction, radiographic outcomes, and complication rates for young patients undergoing primary total hip arthroplasty at ten year follow up. At the current time, little is known about patient outcome in this age group with the above length of follow up.

The purpose of this study is to evaluate the correlation between a novel pelvic sensor that assesses spinopelvic motion with lateral sit-to-stand radiographs, and to evaluate the relationship between a novel pelvic sensor with pelvic tilt, sacral slope, and lumbar lordosis.

This is a prospective clinical trial examining only subjects who undergo THA with PSI. The purpose of this study is to compare the alignment accuracy of patient-specific implants versus traditional off-the-shelf implants in total hip arthroplasty using prior literature-derived data as controls.

Displaced femoral neck fractures are one group of hip fracture patients that are commonly treated with cemented hemiarthroplasty (HA) or total hip arthroplasty (THA). In the elective hip arthroplasty population, the direct anterior approach (DAA) has shown to be effective in helping patients to quickly obtain high postoperative function. This approach has also been shown to be effective in arthroplasty for displaced femoral neck fractures in a few studies. However, the only studies that directly compare two approaches for hip arthroplasty for femoral neck fractures utilize the anterolateral approach (ALA) versus posterior approach (PA) or DAA versus PA. No studies ...

The purpose of this study is to:

• Determine patient reported outcomes following total hip arthroplasty based on surgical approach.
• Determine if the Forgotten Joint Score (FJS)-12 has superior capability to discriminate outcomes in patients with THA compared to the modified Harris Hip Score (mHHS).

This study is designed to:
-analyze effects of surgical treatment
-improve surgical care and quality of life of patients with hip problems/diseases
-ID predictors of surgical outcomes to identify/improve future treatments
-Collect data, images, from patients undergoing surgical treatment of hip disorders (we will not be collecting social security numbers to send to Washington University).

The purpose of this study is to determine when patients have returned to driving a car following total joint arthroplasty and whether or not they were involved in a car accident after their return to driving.

The purpose of this study is to collect the patient’s perspective on total hip arthroplasty (THA) approach in a single-surgeon, crossover cohort of patients who first underwent total hip arthroplasty using a posterior approach followed by a direct anterior (DA) THA.

The purpose of this study is to evaluate two different standards of care to see if the single Double Debridement, Antibiotics and Implant Retention (DAIR) protocol is non-inferior to planned double-DAIR protocols for acute Periprosthetic Joint Infection (PJI) after primary total hip arthroplasty (THA) or  total knee arthroplasty (TKA). Additionally, effectiveness of treatment in terms of infection eradication and cost comparisons will be addressed.

This project is focused on understanding the risk of cognitive impairment and dementia in total hip and total knee arthroplasty patients. It involves 4 aims:

AIM 1. To determine the risk of dementia in patients with TJA. Using the REP, we will identify a population-based cohort of 9,000 TJA patients and a matched cohort of 9,000 non-TJA patients. The overall risk of dementia and subtypes will be compared between the two cohorts.

AIM 2. To determine cognitive function and neuroimaging measures in patients with TJA. Within the existing data from the MCSA cohort (IRB: 14-004401), we ...

The purpose of this study is to assess predictive value or correlation of outcome measures results on patients following a total knee or total hip arthroplasty in order to better predict the time frame taken to achieve certain functional milestones that are pertinent to that patient population.

The purpose of this study is to evaluate time to return of lower extremity motor function following mepivacaine versys low-dose bupivacaine spinal anesthetic among patients undergoing primary total hip arthorplasty (THA) and total knee arthroplasty (TKA).

The purpose of this study is to compare the postoperative pain levels both in the hospital setting as well as daily for two weeks following discharge between patients in the opioid treatment group and those in the non-opioid treatment group.

The purpose of this study is to evaluate the orthopedic patients’ perspective on the use of indwelling foley catheters.

The purpose of this study is to determine the effectiveness of Next Science® Xperience™ Advanced Surgical Irrigation in reducing bacterial bioburden and acute periprosthetic joint infection rates after total hip and knee arthroplasty compared to standard of care irrigation.

The purpose of this study is to assess the impact of a whole food plant-based diet on blood sugar control in diabetic patients versus a control group on the American Diabetics Association diet before having a total hip, knee, or shoulder replacement surgery.

The purpose of the study is to determine the survivorship, clinical outcomes, and mechanisms of failure associated with total hip and knee arthroplasty in patients with osteogenesis imperfecta.

This research study is being done to find out if there is any correlation between metal ion levels (cobalt and chromium) in the fluid around your hip, and those that are found in your blood. One factor that may cause failure of a total hip arthroplasty is an elevated level of these ions around the hip.

PEPPER is a randomized study comparing the three most commonly used anticoagulants in North America in patients who have elected to undergo primary or revision hip or knee joint replacement surgery. The anticoagulants being compared are enteric coated aspirin, low intensity warfarin, and rivaroxaban.

The purposes of this study are to determine:  the risk of cardiomyopathy and heart failure, and cardiac structure and function in patients with THA and TKA. This study will also determine the association between serum and/or synovial fluid metal ion levels with cardiac structure and function in 100 prospectively-recruited THA and TJA patients.

PEPPER is a randomized study comparing the three most commonly used anticoagulants in North America in patients who have elected to undergo primary or revision hip or knee joint replacement surgery. The anticoagulants being compared are enteric coated aspirin, low intensity warfarin, and rivaroxaban.

The purpose of this study is to determine the incremental value of a “star” from the patient perspective when choosing a provider for total joint replacement.

The primary aims of this study are to determine whether extended oral prophylactic antibiotics after primary total joint arthropasty (TJA) decreases the incidence of periprosthetic joint infection (PJI) in a high-risk patient population, and to determine whether extended oral prophylactic antibiotics after primary TJA decreases the incidence of surgical wound complications in a high-risk patient population.

The purpose of this study is to evaluate the clinical outcomes, survivorship, and complications of HIV-positive patients undergoing total hip or total knee arthroplasty at the Mayo Clinic in the past 20 years.

The purpose of this study is to assess the reliability of a single question with a yes or no answer, as a measure of outcome following recovery from total hip or knee replacement.

This study is being conducted to determine gene and protein expression profiles (i.e. which genes and proteins are turned off and on) of those with a possibility of developing osteolysis, infection, arthrofibrosis or metallosis of their THA/TKA.

The purpose of this study is to explore the clinical impact of pain management education using a mobile web-based education delivery system compared to standard education delivery. This study seeks to understand the difference between two different education delivery methodologies and the effect on the postoperative pain experience, including participation in treatment plan, knowledge, pain outcomes, and opioid requirements in patients undergoing major hip (THA) and knee (TKA) arthroplasty. It is hypothesized that a real-time, interactive, mobile education system will demonstrate improved pain associated outcomes and higher patient participation when compared to the current standard education delivery method.

We will collect both non-invasive hemoglobin and conventional serum hemoglobin labs from patients postoperatively following outpatient total joint arthroplasty to determine how closely the values of these two studies correlate in the outpatient total joint arthroplasty patient population.

The objectives of this study are to produce an allogeneic cartilage bank whereby cartilage tissue is obtained from consented donors who meet 21 CFR 1271 donor eligibility criteria, and to simluate clinical implantation of living donor osteochondral allografts banked from Aim 1, demonstrated to meet both viability and sterility requirements, in patients undergoing osteochondral transplantation in the Mayo clinical practice. Actual grafting using collected cartilage will not occur. This is a process validation study.