ClinicalTrials.gg
RecruitingNCT07226973Updated Nov 12, 2025

Gait After THA: Direct Anterior vs Manual Posterior vs Robotic Posterior

An interventional study of Total hip arthroplasty via direct anterior approach (manual, non-robotic) and Total hip arthroplasty via posterior approach (manual, non-robotic) in Osteoarthritis (OA) of the Hip, sponsored by Ochsner Health System. Recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-11-12.

Sponsored by Ochsner Health System · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2025; still recruiting 1 year 1 month later.
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 1,029 studies in Osteoarthritis with a site in United States — 117 open to participants now, 177 under way, 14 of them phase 3. Osteoarthritis · United States.

Planned enrollment
593rd of 832
48 · median 100
Started
2025
with 36 others
No phase
437 of 1,029
55 open now
Primary completion
2027-11
later than 114 of 176 live
Registered
1,000th of 1,029
by date

Among the 1,029 studies in Osteoarthritis with a site in United States, this one is the 593rd largest by planned enrollment of the 832 interventional ones that give a count, is one of 37 that started in 2025, is one of 437 with no phase, reaches primary completion later than 114 of the 176 other live ones, and was the 1,000th registered.

Osteoarthritis

2,974 studies on the registry are indexed under Osteoarthritis; 438 are open to participants now.

Browse Osteoarthritis studies →

Open to participants now

117 of the 1,029 studies in Osteoarthritis with a site in United States are open now. Recruiting first, the newest first:

112 more — sign in →

All 117 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 287 Osteoarthritis studies recruiting now, 158 (55%) set no upper age limit and 72 (25%) stop at 75 or younger; 22 take children under 18; 30 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 1,029 studies in Osteoarthritis with a site in United States, or all of them as a file.
02

Study summary

The purpose of this study is to evaluate the gait biomechanics following THA on 3 groups of subjects undergoing DAA (manual) and PA (manual and robotic) surgical approaches.

Read the detailed description

Single-center, three-arm, partially randomized interventional study comparing gait biomechanics after primary total hip arthroplasty (THA) via (1) manual direct anterior approach (DAA), (2) manual posterior approach (PA), and (3) robotic-assisted posterior approach (rPA). One surgeon's patients are randomized to DAA vs PA; the second surgeon's patients receive rPA per routine practice. Outcomes assessors are blinded (motion-capture suit conceals dressings/scars). Gait and sit-to-stand analyses are performed pre-op and at 6 and 12 weeks post-op using a Vicon motion capture system with force plates and surface EMG. Patient-reported outcomes are collected with standard instruments. The trial evaluates short-term biomechanical recovery and patient-reported outcomes across approaches.

03

Conditions studied

  • Osteoarthritis (OA) of the Hip

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04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adults aged >18 undergoing primary elective THA for osteoarthritis
  • \<35
  • Ability to walk unassisted (cane, walker, wheelchair, ect) for > 150 feet preoperatively

Exclusion criteria

Exclusion Criteria:

  • Previous hip surgery on the affected side
  • Neurological disorders affecting gait
  • to either DAA or PA
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
48 participants (estimated)

Study arms

  • Active comparator
    Manual Direct Anterior Approach (DAA)

    The DAA utilizes an internervous and intermuscular approach, preserving abductor and posterior soft tissues, and is associated with reduced dislocation rates and accelerated early recovery.⁶ However, it carries a steep learning curve and an elevated risk of lateral femoral cutaneous nerve neuropraxia.

    Procedure: Total hip arthroplasty via direct anterior approach (manual, non-robotic)

  • Active comparator
    Manual Posterior Approach

    PA remains the most commonly used technique worldwide, offering extensile exposure and preserved abductor function, though its historical association with increased dislocation risk has necessitated meticulous capsular and soft-tissue repair.

    Procedure: Total hip arthroplasty via posterior approach (manual, non-robotic)

  • Active comparator
    Robotic-Assisted Posterior Approach

    Robotic-assisted THA introduces computer-navigated precision into implant alignment and biomechanical restoration. Contemporary systems (e.g., MAKO) offer intraoperative haptic guidance and preoperative CT-based planning to improve component placement accuracy.

    Procedure: Robotic-assisted total hip arthroplasty via posterior approach

Interventions

  • ProcedureTotal hip arthroplasty via direct anterior approach (manual, non-robotic)

    Primary THA performed via a direct anterior approach without robotic assistance

  • ProcedureTotal hip arthroplasty via posterior approach (manual, non-robotic)

    Primary THA performed via a posterior approach without robotic assistance

  • ProcedureRobotic-assisted total hip arthroplasty via posterior approach

    Primary THA via posterior approach using pre-op CT-based planning and intra-op robotic assistance

06

What researchers measure

Primary outcomes

  1. Walking speed during level gait (m/s)

    Mean self-selected walking speed measured over instrumented walkway during motion-capture trials.

    Time frame: Change from baseline (pre-op) to 6 weeks and 12 weeks post-op.

  2. Peak hip abduction moment during stance (Nm/kg)

    Maximum external hip abduction moment during stance, normalized to body mass.

    Time frame: Change from baseline (pre-op) to 6 weeks and 12 weeks post-op.

  3. EMG- Gluteus medius peak activation at initial contact/loading response

    Peak normalized surface EMG amplitude of the operated-side gluteus medius measured during the initial contact/loading response of level walking. EMG is sampled synchronously with motion capture and force plates, band-pass filtered (\~20-450 Hz), rectified, and low-pass filtered (\~6 Hz) to form a linear envelope. Strides are time-normalized to 0-100% gait cycle; the peak is extracted within 0-10% of the gait cycle (heel strike through loading response). Amplitude is normalized to the participant's maximum voluntary isometric contraction (%MVIC). Participant-level values are the mean of valid trials at each visit.

    Time frame: Change from baseline (pre-op) to 6 weeks and 12 weeks post-op.

Secondary outcomes

  1. postoperative complications-(participants with ≥1 event, %)

    Postoperative complications include, but are not limited to: Surgical \& Local Complications Dislocation Prosthetic Joint Infection (Early or Late) Aseptic Loosening Periprosthetic Fracture Implant Wear (Osteolysis) Wound Complications (Hematoma, Dehiscence) Nerve or Vascular Injury Leg Length Discrepancy Heterotopic Ossification Implant Failure or Breakage Adverse Local Tissue Reaction (Metallosis) Tendon/Muscle Dysfunction Medical \& Systemic Complications Deep Vein Thrombosis (DVT) Pulmonary Embolism (PE) Cardiovascular Events (Heart Attack, Stroke)

    Time frame: through study completion, an average of 1 year

  2. Patient Reported Outcome Measures-HOOS

    Hip Disability and Osteoarthritis Outcome Score. Questionnaire. Range 0-100, higher=better

    Time frame: Baseline; 6 weeks; 12 weeks; 12 months; change from baseline - Score (0-100)

07

Study locations

2 of 2 sites recruiting
08

References and documents

Publications

  • Varin D, Lamontagne M, Beaule PE. Does the anterior approach for THA provide closer-to-normal lower-limb motion? J Arthroplasty. 2013 Sep;28(8):1401-7. doi: 10.1016/j.arth.2012.11.018. Epub 2013 Mar 16. PubMed 23507070 ↗
  • Yan L, Ge L, Dong S, Saluja K, Li D, Reddy KS, Wang Q, Yao L, Li JJ, Roza da Costa B, Xing D, Wang B. Evaluation of Comparative Efficacy and Safety of Surgical Approaches for Total Hip Arthroplasty: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2023 Jan 3;6(1):e2253942. doi: 10.1001/jamanetworkopen.2022.53942. PubMed 36719679 ↗
  • Higgins BT, Barlow DR, Heagerty NE, Lin TJ. Anterior vs. posterior approach for total hip arthroplasty, a systematic review and meta-analysis. J Arthroplasty. 2015 Mar;30(3):419-34. doi: 10.1016/j.arth.2014.10.020. Epub 2014 Oct 22. PubMed 25453632 ↗
  • Yoo JI, Cha YH, Kim KJ, Kim HY, Choy WS, Hwang SC. Gait analysis after total hip arthroplasty using direct anterior approach versus anterolateral approach: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2019 Feb 8;20(1):63. doi: 10.1186/s12891-019-2450-2. PubMed 30736783 ↗
  • Ang JJM, Onggo JR, Stokes CM, Ambikaipalan A. Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol. 2023 Oct;33(7):2773-2792. doi: 10.1007/s00590-023-03528-8. Epub 2023 Apr 3. PubMed 37010580 ↗
  • Putananon C, Tuchinda H, Arirachakaran A, Wongsak S, Narinsorasak T, Kongtharvonskul J. Comparison of direct anterior, lateral, posterior and posterior-2 approaches in total hip arthroplasty: network meta-analysis. Eur J Orthop Surg Traumatol. 2018 Feb;28(2):255-267. doi: 10.1007/s00590-017-2046-1. Epub 2017 Sep 27. PubMed 28956180 ↗
  • Wang Z, Bao HW, Hou JZ. Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis. J Orthop Surg Res. 2019 Feb 26;14(1):63. doi: 10.1186/s13018-019-1095-z. PubMed 30808382 ↗
  • Wang Z, Hou JZ, Wu CH, Zhou YJ, Gu XM, Wang HH, Feng W, Cheng YX, Sheng X, Bao HW. A systematic review and meta-analysis of direct anterior approach versus posterior approach in total hip arthroplasty. J Orthop Surg Res. 2018 Sep 6;13(1):229. doi: 10.1186/s13018-018-0929-4. PubMed 30189881 ↗
  • Fagotti L, Falotico GG, Maranho DA, Ayeni OR, Ejnisman B, Cohen M, Astur DC. POSTERIOR VERSUS ANTERIOR APPROACH TO TOTAL HIP ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Acta Ortop Bras. 2021 Nov-Dec;29(6):297-303. doi: 10.1590/1413-785220212906244610. PubMed 34849093 ↗
  • Barrett WP, Turner SE, Leopold JP. Prospective randomized study of direct anterior vs postero-lateral approach for total hip arthroplasty. J Arthroplasty. 2013 Oct;28(9):1634-8. doi: 10.1016/j.arth.2013.01.034. Epub 2013 Mar 19. PubMed 23523485 ↗
  • Cheng TE, Wallis JA, Taylor NF, Holden CT, Marks P, Smith CL, Armstrong MS, Singh PJ. A Prospective Randomized Clinical Trial in Total Hip Arthroplasty-Comparing Early Results Between the Direct Anterior Approach and the Posterior Approach. J Arthroplasty. 2017 Mar;32(3):883-890. doi: 10.1016/j.arth.2016.08.027. Epub 2016 Aug 31. PubMed 27687805 ↗
  • Rosenlund S, Broeng L, Holsgaard-Larsen A, Jensen C, Overgaard S. Patient-reported outcome after total hip arthroplasty: comparison between lateral and posterior approach. Acta Orthop. 2017 Jun;88(3):239-247. doi: 10.1080/17453674.2017.1291100. Epub 2017 Feb 18. PubMed 28464754 ↗
  • Meneghini RM, Smits SA, Swinford RR, Bahamonde RE. A randomized, prospective study of 3 minimally invasive surgical approaches in total hip arthroplasty: comprehensive gait analysis. J Arthroplasty. 2008 Sep;23(6 Suppl 1):68-73. doi: 10.1016/j.arth.2008.05.014. PubMed 18722305 ↗
  • Petis S, Howard J, Lanting B, Jones I, Birmingham T, Vasarhelyi E. Comparing the anterior, posterior and lateral approach: gait analysis in total hip arthroplasty. Can J Surg. 2018 Feb;61(1):50-57. doi: 10.1503/cjs.003217. Epub 2017 Dec 1. PubMed 29368677 ↗
  • Reininga IH, Stevens M, Wagenmakers R, Boerboom AL, Groothoff JW, Bulstra SK, Zijlstra W. Comparison of gait in patients following a computer-navigated minimally invasive anterior approach and a conventional posterolateral approach for total hip arthroplasty: a randomized controlled trial. J Orthop Res. 2013 Feb;31(2):288-94. doi: 10.1002/jor.22210. Epub 2012 Aug 8. PubMed 22886805 ↗
  • Nelms NJ, Birch CE, Halsey DH, Blankstein M, McGinnis RS, Beynnon BD. Assessment of Early Gait Recovery After Anterior Approach Compared to Posterior Approach Total Hip Arthroplasty: A Smartphone Accelerometer-Based Study. J Arthroplasty. 2020 Feb;35(2):465-470. doi: 10.1016/j.arth.2019.09.030. Epub 2019 Sep 26. PubMed 31629624 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Oct 2025 (actual). Primary completion is estimated for Nov 2027, 25 months after the start.

Of 578 non-industry interventional studies with no phase under Osteoarthritis, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 52. This study's planned 25 months is close to that.

Counting every sponsor, half of 713 studies reached it within 29 months; a quarter within 11 and three quarters within 58.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 28, 2025
First posted
Nov 12, 2025
StartActual
Oct 9, 2025
Primary completionEst.
Nov 15, 2027
CompletionEst.
Nov 15, 2027
Last update
Nov 12, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Nov 12, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07226973
Lead sponsor
Ochsner Health System
Responsible party
Sponsor
First posted
Nov 12, 2025
Start date
Oct 9, 2025
Primary completion
Nov 15, 2027 (estimated)
Completion
Nov 15, 2027 (estimated)
Last update
Nov 12, 2025

Study contacts

George Chimento, MD
Contact
gchimento@ochsner.org
504-736-4800
Ken Bode
Contact
ken.bode@ochsner.org
504-842-1936
George Chimento, MD
principal investigator · Ochsner Health System

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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