BACKGROUND The supercapsular percutaneously-assisted total hip arthroplasty (SuperPath) was proposed to be minimally invasive and tissue sparing with possible superior postoperative outcomes to traditional approaches of total hip arthroplasty (THA). Here, we compared the short-term outcomes of staged THA with the SuperPath or through posterolateral approach (PLA) for bilateral osteonecrosis of the femoral head (ONFH). METHODS Patients with bilateral late-stage ONFH were prospectively recruited from our department from March 2017 to March 2018. Staged bilateral THAs with one side SuperPath and the other side PLA were performed consecutively in the same patients with right and left hips alternating within approaches. The average time interval between the staged THAs was 3 months. Perioperative status (operation time, incision length, intraoperative blood loss, soft tissue damage, and length of hospital stay) and postoperative function (range of motion, pain, and hip function) were recorded and compared between the SuperPath and PLA approaches within 12-month postoperatively. RESULTS Four male patients (age, 51.00 ± 4.54; BMI, 21.49 ± 1.73) with bilateral alcohol-induced ONFH (Ficat III/IV) were followed up over 12 months postoperatively. Compared with the PLA, the SuperPath yielded shorter incision length (7.62 vs. 11.12 cm), longer operation time (103.25 vs. 66.50 min), more blood loss (1108.50 vs. 843.50 ml), deficient abduction angle of the acetabular cup (38.75° vs. 44.50°), and inferior early-term hip function (Harris hip score, 72.50 vs. 83.25) at 12-month postoperatively. Soft tissue damage, length of hospital stay, postoperative pain, postoperative range of motion, and 12-month patient satisfaction were comparable between both approaches. CONCLUSION The SuperPath may be a minimally invasive technique but the present study shows less favorable short-term outcomes than PLA for total hip arthroplasty in osteonecrosis of the femoral head. More investigations are required to provide convincing favorable evidences of the SuperPath over other traditional THA approaches. TRIAL REGISTRATION INFORMATION The trial was retrospectively registered in https://www.researchregistry.com (No. Researchregistry4993) on July 04, 2019. The first participant was enrolled on March 13, 2017.

中文翻译：

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超级囊经皮辅助全髋关节（SuperPath）与后外侧全髋关节置换术在股骨头双侧骨坏死中的临床试验。

背景技术超囊经皮辅助全髋关节置换术（SuperPath）被认为是微创和组织保留的，其术后结果可能优于传统的全髋关节置换术（THA）。在这里，我们比较了分期THA与SuperPath或通过后外侧入路（PLA）治疗股骨头双侧骨坏死（ONFH）的近期结果。方法从2017年3月至2018年3月，从我们的科室前瞻性招募双侧晚期ONFH患者。在同一患者中，左右髋关节交替进路，同时进行具有一侧SuperPath和另一侧PLA的分阶段双侧THA。分阶段THA之间的平均时间间隔为3个月。围手术期状态（手术时间，切口长度，记录术中失血，软组织损伤和住院时间以及术后功能（运动范围，疼痛和髋关节功能），并在术后12个月内比较SuperPath和PLA方法。结果4例男性患者（年龄51.00±4.54； BMI，21.49±1.73）接受双侧酒精诱导的ONFH（Ficat III / IV）术后12个月进行了随访。与PLA相比，SuperPath产生的切口长度更短（7.62 vs. 11.12 cm），更长的手术时间（103.25 vs. 66.50 min），更多的失血（1108.50 vs. 843.50 ml），髋臼杯外展角度不足（38.75）。术后12个月时，早期髋关节功能较差（Harris髋关节评分，72.50对83.25），而早期髋关节功能较差（44.50°对44.50°）。软组织损伤，住院时间，术后疼痛，术后运动范围，两种方法在12个月的患者满意度上具有可比性。结论SuperPath可能是一种微创技术，但本研究显示股骨头坏死的全髋关节置换术的近期短期疗效较PLA差。与其他传统的THA方法相比，还需要进行更多的研究才能提供令人信服的SuperPath令人信服的证据。试验注册信息该试验已于2019年7月4日在https://www.researchregistry.com（编号Researchregistry4993）进行回顾性注册。2017年3月13日注册了第一位参与者。结论SuperPath可能是一种微创技术，但本研究显示股骨头坏死的全髋关节置换术的近期短期疗效较PLA差。与其他传统的THA方法相比，还需要进行更多的研究才能提供令人信服的SuperPath令人信服的证据。试验注册信息该试验已于2019年7月4日在https://www.researchregistry.com（编号Researchregistry4993）进行回顾性注册。2017年3月13日注册了第一位参与者。结论SuperPath可能是一种微创技术，但本研究显示股骨头坏死的全髋关节置换术的近期短期疗效较PLA差。与其他传统的THA方法相比，需要进行更多的研究才能提供令人信服的SuperPath令人信服的证据。试验注册信息该试验已于2019年7月4日在https://www.researchregistry.com（编号Researchregistry4993）进行回顾性注册。2017年3月13日注册了第一位参与者。