Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study

Abstract Background This study aims to evaluate postoperative pain and functional and clinical outcomes of anterolateral supine (ALS) and posterolateral (PL) approaches for primary total hip arthroplasty. Materials and methods We retrospectively examined the joints of 110 patients who underwent primary total hip arthroplasty (THA). The ALS group was compared with the PL group using the pain visual analog scale (VAS) and narcotic consumption as pain outcomes. Functional outcomes included postoperative range of motion (ROM) of hip flexion, day on which patients could perform straight leg raising (SLR), day on which patients began using a walker or cane, duration of hospital stay, rate of transfer, and strength of hip muscles. Clinical outcomes included pre and postoperative Harris Hip Scores. Results No significant differences were found in the pain VAS scores or narcotic consumption between the two groups. The PL group could perform SLR earlier than the ALS group (P < 0.01). The ALS group started using a cane earlier (P < 0.01) and had a shorter hospital stay (P < 0.01) than the PL group. Degrees of active ROM of flexion at postoperative day (POD) 1 were significantly lower in the ALS group than in the PL group (P < 0.01). Regarding hip muscle strength, hip flexion was significantly weaker in the ALS group than in the PL group until 1-month POD (P < 0.01). External rotation from 2 weeks to 6 months postoperatively was significantly weaker in the PL group than in the ALS group (P < 0.01). Conclusion The ALS approach was more beneficial than the PL approach because ALS enabled better functional recovery of the strength of external rotation, improved rehabilitation, and involved a shorter hospital stay. Level of Evidence Level IV retrospective observational study.

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Clinical Outcomes and Midterm Survivorship of an Uncemented Primary Total Hip Arthroplasty System

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.01.063 ◽

2020 ◽

Vol 35 (6) ◽

pp. 1662-1666

Author(s):

Harman Chaudhry ◽

Steven J. MacDonald ◽

James L. Howard ◽

Richard W. McCalden ◽

Douglas D. Naudie ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Clinical Outcomes ◽

Hip Arthroplasty ◽

Total Hip ◽

Primary Total Hip Arthroplasty

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Fast track protocol for primary total hip arthroplasty in non-trauma cases reduces the length of hospital stay: Prospective French multicenter study

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2020.05.017 ◽

2020 ◽

Vol 106 (8) ◽

pp. 1527-1531

Author(s):

Aymard De Ladoucette ◽

Patrice Mertl ◽

Marc-Pierre Henry ◽

Nicolas Bonin ◽

Philippe Tracol ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hospital Stay ◽

Hip Arthroplasty ◽

Multicenter Study ◽

Fast Track ◽

Length Of Hospital Stay ◽

Total Hip ◽

Primary Total Hip Arthroplasty

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Can Surgeons Reduce the Risk for Dislocation After Primary Total Hip Arthroplasty Performed Using the Posterolateral Approach?

The Journal of Arthroplasty ◽

10.1016/j.arth.2017.04.047 ◽

2017 ◽

Vol 32 (10) ◽

pp. 3141-3146 ◽

Cited By ~ 12

Author(s):

Kurt G. Seagrave ◽

Anders Troelsen ◽

Bjørn G. Madsen ◽

Henrik Husted ◽

Thomas Kallemose ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Posterolateral Approach ◽

Total Hip ◽

Primary Total Hip Arthroplasty

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Intraoperative evaluation of the effects of femoral component offset and head size on joint stability in total hip arthroplasty

Journal of Orthopaedic Surgery ◽

10.1177/2309499016684298 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668429 ◽

Cited By ~ 3

Author(s):

Tetsuya Jinno ◽

Daisuke Koga ◽

Yoshinori Asou ◽

Sadao Morita ◽

Atsushi Okawa ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

External Rotation ◽

Head Size ◽

Joint Stability ◽

Femoral Offset ◽

Stability Range ◽

Total Hip ◽

The Stability ◽

Hip Flexion

Purpose: To evaluate intraoperatively the effects of femoral offset and head size on stability of the hip joints in total hip arthroplasty (THA) via posterior approach. Methods: Thirty cementless THAs were included in this study. After acetabular shell and femoral broach fixation, trial reduction was repeated using a femoral neck (5- to 8-mm higher or standard offset) and a head (26 mm or 32 mm). To evaluate joint stability, range of internal rotation (IR) in hip flexion prior to posterior subluxation and range of external rotation (ER) in hip extension were measured. Results: The high-offset neck provided significantly (approximately 10°) greater range of IR to subluxation than the standard-offset neck. No hips ended in anterior subluxation by ER. The head size did not have significant effects on the stability. Conclusion: Results suggest that the 5- to 8-mm greater femoral offset might be effective in preventing instability in primary THA.

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Comparative prospective randomized study of minimally invasive transpiriformis approach versus conventional posterolateral approach in total hip arthroplasty as measured by biology markers

International Orthopaedics ◽

10.1007/s00264-021-05083-5 ◽

2021 ◽

Author(s):

Cong Xiao ◽

Zhixiang Gao ◽

Shaoyun Zhang ◽

Nengji Long ◽

Kai Yao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Hospital Stay ◽

Hip Arthroplasty ◽

Controlled Trial ◽

Randomized Study ◽

Length Of Hospital Stay ◽

Posterolateral Approach ◽

Harris Hip Score ◽

Total Hip

Abstract Background Minimally invasive surgery is becoming increasingly common, but evidence of the advantages of the minimally invasive transpiriformis approach in total hip arthroplasty is limited. Therefore, our single-centre randomized controlled trial evaluated the benefits of this approach versus the posterolateral approach. Methods Forty-nine patients undergoing the minimally invasive transpiriformis approach and 57 patients undergoing the posterolateral approach total hip arthroplasty were analyzed. The operative time, length of hospital stay, incision length, and peri-operative data related to the surgery were recorded. In both groups, serum CRP, IL-6, HGb, Hct, MB, CK-MB, and CK levels, Harris hip scores, and VAS scores were recorded. Results Patients who underwent the minimally invasive transpiriformis approach had a smaller surgical incision (9.10 ± 0.94 vs. 15.56 ± 1.20 cm, P = 0.00) and shorter hospital stay (6.20 ± 1.54 vs. 12.26 ± 2.97 days, P = 0.00) than those who underwent the posterolateral approach. Serum levels of CRP, IL-6, MB, CK-MB, and CK were also lower. According to the Harris hip score, the minimally invasive transpiriformis group showed significant improvement at one week and one month after surgery. Conclusion Compared to the posterolateral approach, the minimally invasive transpiriformis approach for total hip arthroplasty provided rapid functional recovery, elicited a significantly reduced post-operative inflammatory response, and caused less muscle damage.

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The Effect of Femoral Malrotation in Offset Templating for Total Hip Arthroplasty: A Cadaveric Study and Curvilinear Analysis

The Journal of Hip Surgery ◽

10.1055/s-0041-1732367 ◽

2021 ◽

Author(s):

H. Del Schutte ◽

Sergio M. Navarro ◽

Hashim Shaikh ◽

William R. Barfield ◽

Jeffrey Conrad ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Internal Rotation ◽

Hip Arthroplasty ◽

Proximal Femur ◽

External Rotation ◽

Femoral Rotation ◽

Level Of Evidence ◽

Total Hip ◽

Femoral Malrotation ◽

Cadaveric Model

AbstractTechniques allow assessment of preoperative offset in hip arthroplasty. This study assessed femoral rotation in preoperative offset templating using a cadaveric model. Ten femurs were imaged at degrees of rotation. Offset was measured. A generalizable equation predicting change in offset was derived with a curvilinear model. Statistically significant differences at rotational positions were found. For 30 degrees of internal rotation, 2.1 mm change in adjusted mean offset existed; for 30 degrees of external rotation, 8.4 mm change existed. Improved awareness of malrotation of the proximal femur and templating adjustments may improve total hip arthroplasty outcomes. This study reflects level of evidence III.

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Lupus is associated with poorer outcomes after primary total hip arthroplasty

Lupus ◽

10.1177/0961203319851573 ◽

2019 ◽

Vol 28 (7) ◽

pp. 834-842 ◽

Cited By ~ 3

Author(s):

J A Singh ◽

J D Cleveland

Keyword(s):

Total Hip Arthroplasty ◽

Hospital Stay ◽

Hip Arthroplasty ◽

Hospital Charges ◽

Care Utilization ◽

Implant Infection ◽

Total Hip ◽

Inpatient Facility ◽

Modifiable Factors ◽

Primary Total Hip Arthroplasty

Objective The aim of this study was to assess whether lupus is associated with poorer outcomes after primary total hip arthroplasty (THA). Methods We used the 1998–2014 US National Inpatient Sample data. Multivariable-adjusted separate logistic regression models assessed the association of lupus with post-operative complications (implant infection, transfusion, THA revision and mortality) and health care utilization outcomes (total hospital charges, discharge to an inpatient facility and length of hospital stay >3 days) post-THA, adjusting for demographics, underlying diagnosis, comorbidity, insurance payer and hospital characteristics, using odds ratios (OR) and 95% confidence intervals (CI). Results Among 4,116,485 primary THA hospitalizations, 22,557 (0.5%) were in patients with lupus. Patients with lupus were younger and more likely to be female, African-American or Hispanic, living in the South, or to have Medicaid insurance, and had higher comorbidity or lower income. In multivariable-adjusted analyses, the presence of lupus was associated with significantly higher risk of implant infection, transfusion, discharge to an inpatient facility and higher hospital charges above the median, with respective ORs of 1.95 (95% CI, 1.28, 2.97), 1.34 (95% CI, 1.25, 1.43), 1.21 (95% CI, 1.01, 1.44) and 1.38 (95% CI, 1.30, 1.47). Lupus was not significantly associated with the risk of revision, mortality or hospital stay >3 days; the ORs were 1.10 (95% CI, 0.68, 1.78), 0.95 (95% CI, 0.61, 1.47) and 1.06 (95% CI, 0.99, 1.13), respectively. Conclusions Lupus was associated with a higher risk of implant infection, transfusion, discharge to an inpatient facility and higher hospital charges post-primary THA. Insight into modifiable factors associated with these outcomes may improve outcomes in patients with lupus undergoing THA.

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