OGAAP-3 Protocol

OGAAP-3 comparisons will draw on historical data from OGAAP-1 and OGAAP-2 at equivalent follow-up time points because there is no concurrent control group. OGAAP-3 is not a randomised controlled trial but rather synthesises clinical judgement and intraoperative findings into an adaptable care pathway. The protocol's single-centre, non-randomised design limits causal inference regarding comparative effectiveness. All operations are performed by a single surgeon, eliminating procedural variability as a source of bias. OGAAP-3 is informed by more than 1,000 documented cases and adds two further rehabilitation categories beyond OGAAP-2. OGAAP-3 is a prospective, registry-based clinical protocol conducted at a single centre in Sydney with data collection running from June 2023 through December 2027. Approximately 50 patients are enrolled per year, projecting a cohort of around 200 patients with at least two years of follow-up.