The DSA Study
Research type
Research Study
Full title
Pilot Randomised Controlled Trial to determine the safety and early efficacy of the Direct Superior Approach in Total Hip Replacement
IRAS ID
252626
Contact name
Sion Glyn-Jones
Contact email
Sponsor organisation
University of Oxford: Clinical Trials and Research Governance
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Total hip replacement (THR) is routinely performed via a standard posterior or lateral approach. Indeed, 95% of the 90,000 THRs performed in England, Wales and Northern Ireland in 2016 were performed through standard posterior or lateral approaches. These approaches to the hip joint give excellent visualisation of hip anatomy; however, this comes at the cost of a relatively large incision and the sacrifice of some muscle and tendon.
These drawbacks led surgeons to develop techniques to perform THR through smaller incisions, termed minimally invasive THR. Minimally invasive THR has been defined by an incision length of 12 cm or less.
Proponents of minimally invasive THR believe the potential benefits to be a reduction in soft-tissue trauma, shorter intraoperative time, less perioperative blood loss, less postoperative pain, more rapid rehabilitation, earlier hospital discharge, and improved cosmetic appearance. Critics believe that the disadvantages include reduced operative visualization, a steep learning curve, an increased risk of neurovascular complications, a higher prevalence of dislocation, excessive skin trauma, and compromised implant fixation and positioning.
One such minimally invasive approach is the direct superior approach. To investigate whether the direct superior approach is superior than the standard extended posterior approach in total hip replacement, a randomised controlled trial comparing the two is required.
We plan to perform a pilot study, with 30 patients in total, with the aim of investigating whether a fully powered trial would be feasible.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
19/SC/0006
Date of REC Opinion
4 Feb 2019
REC opinion
Further Information Favourable Opinion