The exploration of the differences between two surgical approaches in total hip arthroplasty, direct anterior minimal invasive surgery and Hardinge’s approach, in obese and non-obese hip osteoarthritic patients

2019 ◽  
Author(s):  
Sophia Stasi
10.29007/zddn ◽  
2019 ◽  
Author(s):  
Thomas Apostolou ◽  
Ioanna Chatziprodromidou

Minimal invasive surgery has gained popularity among hip surgeons and patients. Based on early studies, the method is described as a very promising alternative, with low dislocation rates, resulting in a non-traumatic procedure and early functional return. However, complication rates arising of the recent studies raise concern about the applied technique. The aim of the study is to present the clinical results and intra- and post-operative complications of the AMIS procedure in patients with osteoarthritis of the hip, managed with total hip arthroplasty with positioning table, in a 5 years follow up. One senior hip arthroplasty surgeon performed all surgeries. Three hundred eighteen consecutive patients (195 females, 123 males) were clinically and radiologically evaluated, postoperatively 2, 6 and 12 months. Mean patient age was 69.7 years (24 to 88). There was significant improvement according to Harris-Hip Score, ODI, SF-36 scales. The mean incision length was 7.5cm (6 to 8cm). The mean operating time was calculated at 85 minutes. The patients were discharged on the second post-operative day, able to walk with partial weight bearing. One month post-operative, the patients were advised for full weight bearing walking without crutches. Intraoperative complications included two femoral perforations. Postoperative complications included two patients with femoral fractures; one with dislocation; two with superficial infections; three with wound complications; three with femoral stem aseptic loosening; one with ceramic inner fracture and two acetabular component protrusion in the same patient, among which only the last patient had reoperation in both hips. Anterior Minimal Invasive Surgery of the hip is a non-traumatic procedure, associated with reduced pain, faster recovery and no major complications, but requires higher experience level from the hip surgeon.


2020 ◽  
Vol 35 (4) ◽  
pp. 1029-1035.e3 ◽  
Author(s):  
Daniel J. Finch ◽  
Brook I. Martin ◽  
Patricia D. Franklin ◽  
Laurence S. Magder ◽  
Vincent D. Pellegrini

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 815
Author(s):  
Carlo Ricciardi ◽  
Halldór Jónsson ◽  
Deborah Jacob ◽  
Giovanni Improta ◽  
Marco Recenti ◽  
...  

There are two surgical approaches to performing total hip arthroplasty (THA): a cemented or uncemented type of prosthesis. The choice is usually based on the experience of the orthopaedic surgeon and on parameters such as the age and gender of the patient. Using machine learning (ML) techniques on quantitative biomechanical and bone quality data extracted from computed tomography, electromyography and gait analysis, the aim of this paper was, firstly, to help clinicians use patient-specific biomarkers from diagnostic exams in the prosthetic decision-making process. The second aim was to evaluate patient long-term outcomes by predicting the bone mineral density (BMD) of the proximal and distal parts of the femur using advanced image processing analysis techniques and ML. The ML analyses were performed on diagnostic patient data extracted from a national database of 51 THA patients using the Knime analytics platform. The classification analysis achieved 93% accuracy in choosing the type of prosthesis; the regression analysis on the BMD data showed a coefficient of determination of about 0.6. The start and stop of the electromyographic signals were identified as the best predictors. This study shows a patient-specific approach could be helpful in the decision-making process and provide clinicians with information regarding the follow up of patients.


2017 ◽  
Vol 96 (7) ◽  
pp. 473-478 ◽  
Author(s):  
Monika Engdal ◽  
Olav A. Foss ◽  
Kristin Taraldsen ◽  
Vigdis S. Husby ◽  
Siri B. Winther

2015 ◽  
Vol 97 (1) ◽  
pp. 11-16 ◽  
Author(s):  
JR Berstock ◽  
AW Blom ◽  
AD Beswick

Introduction Total hip arthroplasty is one of the most commonly performed orthopaedic procedures. Despite this, medical evidence to inform the choice of surgical approach is lacking. Currently in the UK, the two most frequently performed approaches to the hip are the posterior and the direct lateral. Methods This systematic review was performed according to Cochrane guidelines following an extensive search for prospective controlled trials published in any language before January 2014. Of the 728 records identified from searches, 6 prospective studies (including 3 randomised controlled trials) involving 517 participants provided data towards this review. Findings Compared with the lateral approach, the posterior approach conferred a significant reduction in the risk of Trendelenburg gait (odds ratio [OR]: 0.31, p=0.0002) and stem malposition (OR: 0.24, p=0.02), and a non-significant reduction in dislocation (OR: 0.37, p=0.16) and heterotopic ossification (OR: 0.41, p=0.13). Neither approach conferred a functional advantage. We draw attention to the paucity of evidence and the need for a further randomised trial.


2012 ◽  
Vol 45 (12) ◽  
pp. 2109-2115 ◽  
Author(s):  
Giulia Mantovani ◽  
Mario Lamontagne ◽  
Daniel Varin ◽  
Giuliano G. Cerulli ◽  
Paul E. Beaulé

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