NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
 
Status In progress
Process IP
ID number 1842
Description Supercapsular percutaneously assisted THA is also described as the 'SuperPath' approach. It is a minimally invasive approach to THA. The aim, as with standard posterior or direct lateral approaches, is to reconstruct the hip to reduce symptoms and improve hip function, but with smaller cuts and less tissue damage. The procedure is done under general or regional anaesthesia. The patient is usually put in the standard lateral decubitus position with the hip in 45 degrees of flexion and 10 to 15 degrees of internal rotation. A cut is made superior to the greater trochanter. The gluteal fascia is cut, the gluteus maximus muscle is split, the gluteus medius and minimus muscles are retracted anteriorly, and the piriformis tendon is retracted posteriorly. Once the joint capsule is exposed, it is cut from the base of the greater trochanter to 1 cm proximal to the acetabular rim. The femoral canal is then reamed and broached without dislocation. The femoral neck is osteotomised and the femoral head removed. The implant trial cup is placed into the acetabulum to allow access of instruments for its preparation. A second cut is made and using an external guide, a distal and posterior portal is then formed for acetabular reaming. Once the acetabulum is reamed, the definitive acetabular component and polyethylene liner are inserted and secured. Trial femoral components are reduced and tested for stability and tissue tension. Once the trial components are removed, the definitive femoral stem is inserted and the femoral head implanted. The hip joint capsule is preserved and closed with a suture. Then the gluteal fascia and skin are closed with sutures. The procedure usually takes about 2 hours. Specific cementless implants and various specialised instruments are used. Postoperative rehabilitation is recommended for muscle strengthening and mobility.

Provisional Schedule

Interventional procedure consultation 02 December 2021 - 13 January 2022

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For further information on how we develop guidance, please see our page about NICE interventional procedures guidance