In London, a trial will be conducted to compare functional, clinical, and radiological outcomes in THA (total hip arthroplasty) performed utilizing the PA (Posterior approach) when compared to DSA (direct superior approach). The findings of this analysis will yield important outcomes regarding differences in accuracy of implant positioning, functional outcomes, implant survivorship, gait, cost-effectiveness, component stability, complications, and patient satisfaction both approaches for THA.

The DSA is a minimally invasive alteration of the PA. During THA, DSAs preserves the iliotibial band and short external rotators except for the piriformis or conjoint tendon.
A prospective single-center double-blinded randomized control trial will be conducted for THA to compare DSA and PA. The study will recruit 80 patients with symptomatic hip OA (osteoarthritis) undergoing primary THA. Utilizing an online random number generator, participants would be randomly assigned (1:1 ratio) to either PA (control) group or DSA (investigation) group for THA.

Patients will be reviewed by blinded observers at regular intervals for 2 years after surgery. This will help to record predefined study endpoints. To examine whether the DSA offers improved outcomes compared to the PA for THA, a superiority study design will be utilized. To quantify and draw inferences on differences in the efficacy of treatment between the two groups, evaluation of study outcomes in DSA and PA will be utilized. Per-protocol population and Intention-to-treat analysis will be undertaken.

Details regarding the trial timelines have been presented in the following Table.  

Data will be analyzed utilizing the following statistical methods: independent t-test, paired t-test, analysis of variance, descriptive statistics, Fisher exact test, graphical displays, and chi-square test.