Early Recovery Outcomes in Patients Undergoing Total Hip Arthroplasty Through a Posterior Approach with Modified Postoperative Precautions

2021 ◽  
Author(s):  
Yannick Goeb ◽  
Ethan Krell ◽  
Joseph Nguyen ◽  
Kaitlin M. Carroll ◽  
Seth A. Jerabek ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Early Recovery ◽  
Total Hip

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

2020 ◽  
Vol 234 (9) ◽  
pp. 966-974
Author(s):  
Joel Moktar ◽  
Alan Machin ◽  
Habiba Bougherara ◽  
Emil H Schemitsch ◽  
Radovan Zdero
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Failure Load ◽  
The Elderly ◽  
Clinical Failure ◽  
Total Hip

This study provides the first biomechanical comparison of the fixation constructs that can be created to treat transverse acetabular fractures when using the “gold-standard” posterior versus the anterior approach with and without a total hip arthroplasty in the elderly. Synthetic hemipelvises partially simulating osteoporosis (n = 24) were osteotomized to create a transverse acetabular fracture and then repaired using plates/screws, lag screws, and total hip arthroplasty acetabular components in one of four ways: posterior approach (n = 6), posterior approach plus a total hip arthroplasty acetabular component (n = 6), anterior approach (n = 6), and anterior approach plus a total hip arthroplasty acetabular component (n = 6). All specimens were biomechanically tested. No differences existed between groups for stiffness (range, 324.6–387.3 N/mm, p = 0.629), clinical failure load at 5 mm of femoral head displacement (range, 1630.1–2203.9 N, p = 0.072), or interfragmentary gapping (range, 0.67–1.33 mm, p = 0.359). Adding a total hip arthroplasty acetabular component increased ultimate mechanical failure load for posterior (2904.4 vs. 3652.3 N, p = 0.005) and anterior (3204.9 vs. 4396.0 N, p = 0.000) approaches. Adding a total hip arthroplasty acetabular component also substantially reduced interfragmentary sliding for posterior (3.08 vs. 0.50 mm, p = 0.002) and anterior (2.17 vs. 0.29 mm, p = 0.024) approaches. Consequently, the anterior approach with a total hip arthroplasty may provide the best biomechanical stability for elderly patients, since this fixation group had the highest mechanical failure load and least interfragmentary sliding, while providing equivalent stiffness, clinical failure load, and gapping compared to other surgical options.

A prospective randomised comparison of earlier function after total hip arthroplasty with a mini posterior approach or supercapsular percutaneously-assisted total hip approach: a gait analysis study

2021 ◽  
pp. 112070002110184
Author(s):  
Andrey A Korytkin ◽  
Younes M El Moudni ◽  
Yana S Novikova ◽  
Kirill A Kovaldov ◽  
Ekaterina A Morozova
Keyword(s):  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Gait Velocity ◽  
Harris Hip Score ◽  
Kinematic Parameters ◽  
Gait Patterns ◽  
Total Hip

Background: The supercapsular percutaneously-assisted total hip (SuperPATH) approach is a muscle sparing surgical technique for total hip arthroplasty (THA). The literature reports good clinical and functional results of the SuperPATH technique in the short term. We aimed to compare early outcomes and gait analysis of THA using the mini posterior approach (MPA) and supercapsular percutaneously-assisted total hip (SuperPATH) approach. Methods: 44 patients who underwent THA, were randomly allocated to either MPA or SuperPATH. The data were then collected prospectively (preoperatively and postoperatively at 6 weeks). Plain anteroposterior radiographs of the pelvis and instrumental gait analysis were obtained. The visual analogue scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Scores (HOOS) were used to assess functional and clinical outcomes. Results: No significant difference was found in patients’ surgical outcomes. Patients in the SuperPATH group had less pain according to the VAS score at follow-up than the MPA group ( p < 0.01). There was also a significant improvement in HHS and HOOS scores for all patients ( p < 0.001) with the SuperPATH group showing superior changes. The comparison of mean differences in gait velocity between preoperative and 6 weeks postoperative result, revealed improvement in the SuperPATH group over the MPA group ( p = 0.06). Limping was more persistent in the MPA group. Kinematic parameters demonstrated improved hip joint excursion slightly higher in the MPA group. There was no significant improvement in kinetic and kinematic parameters at different walking moments for all patients at 6 weeks compared to preoperative gait patterns. Conclusions: SuperPATH and MPA both show excellent results. This study reveals that the SuperPATH technique was associated with lower postoperative pain levels, and higher physical function and quality of life. Improved functional outcomes allowed earlier postoperative rehabilitation and faster recovery. Specific improvement in gait patterns were identified with nonsignificant differences between the 2 approaches at 6 weeks follow-up.

scholarly journals Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

2015 ◽  
Vol 9 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Motohiro Wakui
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Dislocation Rate ◽  
Rank Test ◽  
Consecutive Series ◽  
Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

Patient’s perspective on direct anterior versus posterior approach total hip arthroplasty

2018 ◽  
Vol 42 (12) ◽  
pp. 2771-2775 ◽  
Author(s):  
Dragan Radoicic ◽  
Vladimir Zec ◽  
Walaa Ikram Elassuity ◽  
Mostafa Abdelmaboud Azab
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Total Hip ◽  
Patient’S Perspective

Incidence of Heterotopic Ossification Following a Multimodal Pain Protocol in Total Hip Arthroplasty With the Posterior Approach

Orthopedics ◽  
2017 ◽  
Vol 41 (1) ◽  
pp. e92-e97 ◽  
Author(s):  
Peter B. White ◽  
Prem N. Ramkumar ◽  
Morteza Meftah ◽  
Narges Ghazi ◽  
Amar S. Ranawat ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Total Hip

A Comparison of Risk of Dislocation and Cause-Specific Revision Between Direct Anterior and Posterior Approach Following Elective Cementless Total Hip Arthroplasty

2020 ◽  
Vol 35 (6) ◽  
pp. 1651-1657 ◽  
Author(s):  
Mark Charney ◽  
Elizabeth W. Paxton ◽  
Ronald Stradiotto ◽  
John J. Lee ◽  
Adrian D. Hinman ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty
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