RCT: Direct Superior Approach vs Posterior Approach THA
Research type
Research Study
Full title
A prospective randomised controlled trial comparing the direct superior approach versus the posterior approach for total hip arthroplasty
IRAS ID
231646
Contact name
Fares Haddad
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
The surgical approach in total hip arthroplasty (THA) is the anatomical route taken by the surgeon to the worn out and arthritic parts of the hip joint. Understanding the surgical approach in THA is important because it influences clinical recovery, risk of complications, and implant positioning. The objective of this study is to compare differences in patient recovery and implant stability between the posterior approach and direct superior approach for THA.
This prospective study includes 80 patients with hip arthritis undergoing THA at University College London Hospital. Following informed consent, patients will be randomised to undergo THA using either the posterior approach or direct superior approach. The posterior approach involves the release of the soft tissue sleeve around the hip joint called the iliotibial band. Small muscles called the short hip external rotators are also released and then repaired following insertion of the implants. The direct superior approach is a modification of this technique that uses a similar skin incision but preserves the iliotibial band and some short hip external rotators. Patients will remain blinded to the surgical approach received throughout the study period. Following surgery, patients in both groups will undergo identical rehabilitation programmes and regular follow up by blinded observers for two years. Twenty-five patients from each treatment group will also undergo radiosteriometric analysis to assess implant stability. This is a validated technique that uses fixed bone markers and serial radiographs after surgery to detect early implant migration and predict implant survival.
The findings of this study will lead to an improved understanding of the differences in patient recovery and implant stability between the direct superior approach and posterior approach for THA. This will help to develop the optimal THA procedure with faster rehabilitation, improved patient function, and increased implant survivorship.
REC name
London - Fulham Research Ethics Committee
REC reference
17/LO/1972
Date of REC Opinion
28 Nov 2017
REC opinion
Favourable Opinion