Short-term Results of SuperPATH Versus Direct Lateral Approach In Primary Total Hip Arthroplasty: A Randomized Controlled Study.

Total hip arthroplasty (THA) has shown great success in relieving joint pain and disability and has been a procedure of choice for the treatment of end-stage degenerative joint diseases and trauma.

There are multiple surgical approaches for THA, including the traditional posterior approach, anterior approach, lateral approach, anterolateral approach and posterolateral approach; each has its advantages and complications.

Modified direct lateral approach is considered as standard, most commonly used and familiar in Assiut university Arthroplasty centre. Yet it may cause abductor weakness, post operative pain, prolonged rehabilitation time and more blood loss.

In the past two decades, the group of micro-posterior approaches was introduced. In 2004 Stephen Murphy developed the Supecapsular (SuperCap) approach, preparing the hip insitu to reduce soft tissue traumatization caused by the dislocation manoeuvre used in the conventional posterior approach. , In 2008 Brad Penenberg developed the percutaneously-assisted total hip (PATH) app, a tissue-sparing approach leading through the interval between gluteus medius and the conjoined tendon of the external rotators.

In2011, James Chow described the supercapsular percutaneously-assisted total hip (SuperPATH) approach, the most Important features of SuperPATH are the following: (a) muscle sparing between gluteus medius and piriformis without detaching external rotator tendons or disrupting the hip capsule, (b) femur preparation first without dislocation (c) percutaneous acetabular preparation.

SuperPATH approach is designed to reduce soft tissue trauma and so blood loss, post operative pain, improve joint stability and allow earlier mobilization of patients.

Despite the theoretical advantages of the SuperPATH approach, its adoption remains limited compared with conventional surgical approaches. Furthermore, there is ongoing debate regarding its clinical superiority in terms of functional outcomes, complication rates and implant position.

Aim of our study is to evaluate the clinical and functional outcomes of total hip arthroplasty performed using SuperPATH compared to modified direct lateral approach.

Study Overview

• Status: Not yet recruiting
• Conditions: Compare Two Surgical Approaches Used in Total Hip Arthroplasty
• Intervention / Treatment: Procedure: Surgical approaches: direct lateral approach for the hip and SuperPATH approach

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Islam Mohamed Abd el hameed, Assistant lecturer; Phone Number: 0201016329653; Email: islammohamed846@yahoo.com
• Study Contact Backup: Name: Mohamed Mostafa Alaa eldin and el aziz, Assistant professor; Phone Number: 0201096967747; Email: Mohamed.m.alaa@aun.edu.eg

Study Locations

• Egypt
  • Asyut Governorate
    • Asyut, Asyut Governorate, Egypt
      • Assiut University hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Primary total hip arthroplasty.
2. Age > 18 years.
3. Body mass index < 40 kg/m2.
4. Able to ambulate preoperative.

Exclusion Criteria:

1. Hip deformity (acetabular or femoral).
2. Ankylosed hips.
3. Severe osteoporosis.
4. Neuromuscular disorders.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Direct lateral approach; total hip arthroplasty via direct lateral approach	Procedure: Surgical approaches: direct lateral approach for the hip and SuperPATH approach; Direct lateral approach is approach through the intra muscular septum of gluteus medial muscle SuperPATH approach is minimally invasive posterolateral approach for the hip
Experimental: SuperPATH; This arm will include patients who will undergo total hip arthroplasty via SuperPATH approach	Procedure: Surgical approaches: direct lateral approach for the hip and SuperPATH approach; Direct lateral approach is approach through the intra muscular septum of gluteus medial muscle SuperPATH approach is minimally invasive posterolateral approach for the hip

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Harris hip score	Immediately post operative 3 months 6 months One year Two years

Secondary Outcome Measures

Outcome Measure	Time Frame
Oxford hip score	Immediately post operative 3 months 6 months One year Two years
Visual analogue score	Immediately post operative 3 months 6 months One year Two years
Operative time in minutes	Duration of the operation

Collaborators and Investigators

• Sponsor: Assiut University

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2029

Study Registration Dates

• First Submitted: May 30, 2026
• First Submitted That Met QC Criteria: June 5, 2026
• First Posted (Actual): June 8, 2026

Study Record Updates

• Last Update Posted (Actual): June 8, 2026
• Last Update Submitted That Met QC Criteria: June 5, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: SuperPATH, total hip arthroplasty
• Other Study ID Numbers: ORTHO-2026-015

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No