This study involves comparing the outcomes after using the Direct Anterior Approach (DAA) and the Supercapsular Percutaneously Assisted Total Hip (SuperPATH) approach. These are two approaches to hip replacement that both replace hips without cutting any muscles. DAA approach has been used for many years, but it has a high learning curve and can be difficult for doctors to use, it is however linked with fewer complications when performed by an experienced doctor. SuperPATH is a newer technique which has been shown in studies to be adopted with less complications even during the learning phase. It also shows cost-saving results, showing a reduced length of stay for patients and better 30-day readmission rates. There is pressure on surgeons, from both patients and administration to use techniques that spare tissue, offer early functionality without compromising long-term outcomes. The SuperPATH can meet this benchmark but uptake has been slow, the investigators believe that it is due to the learning curve shown by this approach. The senior surgeon at The Ottawa Hospital is experienced in both techniques, using a trial the investigators can compare the two techniques and help encourage surgeons to change to a procedure that has demonstrated a low complication profile.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Direct Anterior Approach surgery to replace the hip.
SuperPATH approach surgery to replace the hip.
The Ottawa Hospital
Ottawa, Ontario, Canada
RECRUITINGChange from baseline in Hip disability and Osteoarthritis Outcome Score (HOOS) activities of daily living (ADL)
This asks the patient how their hip functions during their daily life. It has 5 subscales measuring Pain, Symptoms, ADL, Sports/Recreation and Quality of Life (which is calculated using all the subscores). Each subscale is calculated using the mean score, with each score range being from 0 to 4. The subscore is normalized such that the lower the number the more extreme the problem is. To calculate Quality of Life, the mean of the other 4 subscores are taken to calculate the score.
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in Gait analysis
This is done by a biomechanics lab for a subsection of 30 patients to test their hip movements.
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in EQ-5D-5L
Generic health status. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. These scores are not aggregated. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. The last page is asking the participant to self score their health that day out of 100.
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in Pre-post Hgb
Checks blood oxygen level
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 2 weeks post-operatively.
Change in Visual Analog Scale (VAS) Pain Score
To measure pain. This is a line with left most end representing no pain with the rightmost representing extreme pain. The participant puts a line where they feel that day and it is measured with a ruler to determine score out of 100. The line is 100mm long.
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 2 weeks post-operatively.
Change in Complication rates
Complications such as fractures that the participant experiences will be assessed
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Readmission rates
Any readmission rates for the participant
Time frame: 3 months post-operatively
Change in Timed-up-and-go (TUG)
The time it takes for the participant to get up from a chair walk 3 metres forward and back and sit back down
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in Timed-Stair-Climb (TSC)
The time it takes for a participant to go up and down a flight of 10 stairs.
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in Range of Motion (ROM)
IR and ER ROM at flexion and extension, this is measured using a goniometer (which is an instrument that measures an angle).
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
Change in X-rays (AP pelvis & lateral)
To check how their bones are faring in their hip area
Time frame: This is from baseline (can be measured anytime to a maximum of one month before surgery) to 12 months post-operatively.
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