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The Supercapsular Percutaneously Assisted Total Hip Approach Does Not Provide Any Clinical Advantage Over the
Yousef Tawfik Khoja1,2,3,4, Ahmed Ayman Habis1,4, Gavin C A Wood1
1Department of Orthopaedic Surgery, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
Clinical Orthopaedics and Related Research
|November 9, 2022
Summary
The SuperPATH approach for total hip replacement showed no significant functional or patient-reported outcome improvements compared to the posterior approach. While opioid use was initially lower with SuperPATH, overall benefits were minimal and transient.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Total Hip Arthroplasty (THA)
Background:
- The SuperPATH (supercapsular percutaneously assisted total hip) approach is a less-invasive surgical technique for THA, potentially offering benefits like reduced pain and faster recovery.
- Limited randomized controlled trials exist comparing the SuperPATH technique to standard surgical approaches for total hip replacement.
Purpose of the Study:
- To evaluate early functional outcomes (Timed Up and Go, Timed Stair Climbing tests) within 100 days post-surgery.
- To compare patient-reported outcomes (Oxford Hip Scores) within 3 months post-surgery.
- To assess differences in pain, opioid consumption, mobility aid use, and return to work between SuperPATH and posterior THA approaches.
Main Methods:
- A randomized controlled trial involving 46 patients (25 SuperPATH, 21 posterior approach) comparing surgical techniques for total hip arthroplasty.
- Functional assessments included Timed Up and Go (TUG) and Timed Stair Climbing (TSC) tests.
- Patient-reported outcomes (Oxford Hip Scores), pain scores, opioid consumption, and time to discontinue mobility aids/return to work were recorded.
Main Results:
- No significant differences were observed in TUG or TSC test times between the SuperPATH and posterior approach groups at any timepoint.
- Oxford Hip Scores and pain scores showed no significant differences between the groups postoperatively.
- Opioid consumption was lower in the SuperPATH group during the first two weeks, but this difference disappeared by week 4. Return to work and mobility aid discontinuation were similar between groups.
Conclusions:
- The SuperPATH approach did not demonstrate clinical advantages over the standard posterior approach in this randomized trial.
- While a short-term reduction in pain was noted, the SuperPATH approach resulted in more complications and offered no significant long-term benefits.
- Routine use of the SuperPATH approach is not recommended until larger trials demonstrate clinically significant patient-relevant differences.
