A Trial Comparing Mini-posterior Approach and Direct Anterior Approach
Condition: Osteoarthritis
MeSH terms: Osteoarthritis
Study type: Interventional

Summary: 
      The purpose is to determine if differences exist in the attainment of functional milestones
      that reflect activities of daily living between mini-posterior and direct anterior approach
      total hip arthroplasty (THA). The investigators also hope to determine if the general health
      outcome after direct anterior total hip arthroplasty was better than that after
      mini-posterior-incision total hip arthroplasty as measured with Short Form-12 (SF-12) scores,
      and to evaluate variation of surgical factors of the two procedures on the basis of the
      operative time, component positioning, and occurrence of early complications.
    

Detailed description: 
      A number of studies have compared surgical approach for total hip arthroplasty. The influence
      of surgical outcome as a function of approach comparing mini-posterior to direct anterior has
      not been reported in a randomized, prospective manner.

      Standard primary total hip arthroplasty (THA) can reliably alleviate pain, improve function,
      and improve the quality of life in a broad section of patients with end stage arthrosis of
      the hip. However, minimally invasive approaches, such as the direct anterior and
      mini-posterior approaches, have been devised with the goal of decreasing peri-operative pain,
      speed early postoperative function, and improve patient satisfaction with the procedure,
      compared with standard THA. These patient centered goals are combined with the surgeon's
      desire of a safe, reproducible minimally invasive procedure that has durable, properly
      positioned components.

      There are currently no prospective, randomized studies comparing the direct anterior approach
      to total hip arthroplasty with other minimally invasive approaches. The mini-posterior
      approach has been studied extensively, with promising results. Others have compared the
      mini-posterior approach with other minimally invasive procedures, and at the current time,
      has the most prospective data demonstrating its superiority as a minimally invasive approach.
      Pagnano performed a prospective, randomized trial comparing the early clinical results of
      mini -posterior THA with Two-incision THA. The results found that the early attainment of
      functional milestones was shorter in the mini-posterior group.

      The purpose is to determine if differences exist in the attainment of functional milestones
      that reflect activities of daily living between mini-posterior and direct anterior approach
      total hip arthroplasty (THA). The investigators also hope to determine if the general health
      outcome after direct anterior total hip arthroplasty was better than that after
      mini-posterior-incision total hip arthroplasty as measured with Short Form-12 (SF-12) scores,
      and to evaluate variation of surgical factors of the two procedures on the basis of the
      operative time, component positioning, and occurrence of early complications.
    

Intervention name(s): Mini-Posterior surgical approach for total hip arthroplasty; Direct Anterior surgical approach for total hip arthroplasty
Intervention type(s): Procedure; Procedure
Intervention description(s): Mini-Posterior surgical approach for total hip arthroplasty; Direct Anterior surgical approach for total hip arthroplasty
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: total hip arthroplasty