Related Experiment Video
Updated: Feb 7, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Clinical and Patient-Reported Outcomes of the SuperPath Versus Hardinge Approach in Total Hip Replacement for
Akın Sönmezdağ1,2, Michelle Dowsey2, Marta Fiocco1,3,4
1Leiden University Medical Centre, Leiden University, Leiden, the Netherlands.
Background:
There are various surgical approaches for total hip replacement (THR), such as the Direct Lateral (Hardinge), anterior, and supra-acetabular (SuperPath) approach. The aim of this study was to compare the post-operative clinical, functional and quality of life outcomes of the SuperPath and Direct Lateral approach in hip osteoarthritis patients undergoing THR.
Methods:
A retrospective analysis was performed of a single-surgeon consecutive cohort of THR's. Data was obtained from the St. Vincent's Melbourne Arthroplasty Outcomes (SMART) Registry, for all THR's between 01-01-2012 and 31-12-2019. Primary outcomes were the patient-reported WOMAC and VR12, measured at pre-op, 12- and 24-month timepoints. Groups were compared using a mixed-model analysis adjusted for potential confounders. Secondary outcomes were length of stay, surgery duration, complications, readmissions, and reoperations.
Results:
384 patients were analysed (259 Direct Lateral; 125 SuperPath). Total WOMAC Scores were significantly better for the SuperPath group (mean diff: 7.1, 95% CI 0.76-13.54, p = 0.02). VR12 Total Scores were significantly higher for SuperPath patients (mean diff: 3.9, 95% CI 0.53-7.35, p = 0.02). For secondary outcomes, the SuperPath approach had a shorter operation time than the Direct Lateral approach (81.9 min vs. 85.8 min, mean difference 3.8, 95% CI: 0.14-7.50, p = 0.04).
Conclusion:
Although the SuperPath approach led to slightly better pain, function and quality of life outcomes than the Direct Lateral approach, the difference was below the minimal clinically important difference (MCID) although statistically significant. There were no differences in other clinical outcomes except for shorter surgery duration, presumably since there were more cemented procedures in the Direct Lateral group.
More Related Videos
Related Concept Videos
Data Reporting and Recording
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Predicting Reaction Outcomes
Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
Hypertension III: Clinical Manifestations and Diagnostic Studies
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

