Comparison of supercapsular percutaneously assisted approach total hip versus conventional posterior approach for total hip arthroplasty: a prospective, randomized controlled trial

Background: Total hip arthroplasty (THA) has been one of the most successful orthopedic procedures over the past 30 years. Nowadays, the techniques of exposure for THA have undergone great changes, allowing surgeons to perform THA through mini-incisions. Recently, a novel minimally invasive surgical technique of the supercapsular percutaneously assisted total hip arthroplasty was reported in 2011. The purpose of this study was to compare the SuperPath approach with the conventional posterior approach, in terms early outcomes and radiologic results. Methods: Ninety-two consecutive unilateral primary hip osteoarthritis adult patients were randomly divided into two groups. Forty-six patients (SuperPath group) were operated on using the SuperPath approach, and 46 patients (conventional group) were operated on with the conventional posterior approach. Outcomes were evaluated using preoperative index, intraoperative data, and postoperative function data. The positioning of the implants was analyzed by radiography. Results: No significant difference was detected in skin-to-skin operation time, blood loss, transfusion rate, postoperative complications, abduction angle, anteversion angle, and stem alignments. The incision length and length of stay (LOS) in the SuperPath group were significantly lower. The VAS score in the SuperPath group at the 1-week, 1-month and 3-month postoperative intervals were lower than those VAS scores in the conventional group. The Harris Hip Score and Barthel Index (BI) for Activities of Daily Living in the SuperPath group were significantly higher at the 1-and 3-month follow-up intervals and were not significantly different 1 year after operation. Conclusions: This prospective randomized study reveals that the SuperPath technique was associated with shorter LOS, earlier time to walk and climb, and lower postoperative pain levels. It also allowed early postoperative rehabilitation and faster recovery than conventional technique.