Screening Muscle strength in Arthroscopic Surgery of the Hip (SMASH)
Research type
Research Study
Full title
Screening Muscle strength in Arthroscopic Surgery of the Hip (SMASH)
IRAS ID
248605
Contact name
Vikas Khanduja
Contact email
Sponsor organisation
Cambridge University Hospitals
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 7 months, 28 days
Research summary
Hip arthroscopy is a key-hole surgical procedure performed for hip pain in young adults. One of the commonest indications for hip arthroscopy is a condition called ‘femoroacetabular impingement’, which is a precursor to arthritis, requiring hip replacement. Arthroscopic surgery addresses the cause of an incongruent joint in patients with FAI.
The frequency of the procedure is increasing, 14,000 operations are projected annually, at an approximate cost of £100 million to the NHS. Recent trials have found a significant improvement in pain following the procedure, however, this was limited to a proportion of the patients. The reasons are not fully known, and although the effect of hip muscle strength has been implicated, but never been investigated in depth.
If a link were established, we could avoid performing surgery on patients who are likely to have a poor outcome; preventing unnecessary and potentially harmful surgery. An annual saving of £15 million is estimated.
Patients awaiting arthroscopy will undergo strength testing before and after the operation. There will be no deviation of treatment from their standard of NHS care. Standardised questionnaires will be used to evaluate the success of the operation after five months. For a selection of ten participants, muscle will be further investigated using electromyography (trace of muscle contraction).Muscle strength-testing will be performed using a motorised dynamometer (Cybex machine), which resembles a piece of gym equipment. Hip movements will be performed while the patient is strapped in and the muscle strength measured using the accurate digital equipment. This process takes 30 minutes and is precede by 5 minutes of warm-up on a stationary bike.
Surface-EMG used sticky 'dots' attached to the skin of the thigh to obtain a trace of muscle contraction during the muscle strength measurements. This dot is removed after testing and does not break the skin or leave a mark.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
20/WM/0052
Date of REC Opinion
25 Feb 2020
REC opinion
Further Information Favourable Opinion