Direct Superior Approach Versus PosteroLateral Approach in Total Hip Arthroplasty: a Multicenter Double Blinded Randomized Controlled Trial

What this Trial Is About

Researchers are comparing two surgical methods for total hip arthroplasty (THA) in patients with disabling hip osteoarthritis: the posterolateral approach (PLA), considered the standard, and the direct superior approach (DSA). This study aims to assess differences in postoperative pain, health-related quality of life (HRQoL), physical function, rehabilitation, urinary incontinence, muscle atrophy, and implant positioning. A new CT imaging technique to reduce metal artifacts will also be evaluated. Participants will be randomly assigned to receive THA via either the PLA or DSA method. Both groups undergo surgery followed by assessments at multiple timepoints: before surgery, and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months afterward. The study includes a double-blind design where neither patients nor researchers know the surgical method used until one year post-surgery. CT scans will be used to measure muscle atrophy, implant positioning, and to validate the new imaging technique. During the study, participants will complete various physical function tests and questionnaires assessing pain, quality of life, and urinary incontinence at scheduled visits. Muscle atrophy and implant placement will be examined with CT scans preoperatively and at 12 months postoperatively. Researchers will also monitor for complications such as infections or dislocations. The primary outcome focuses on physical function measured by the Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) over one year.

Direct Superior Approach Versus PosteroLateral Approach in Total Hip Arthroplasty (SPLAsH)