Direct superior approach for total hip arthroplasty

2021 ◽  
Vol 103-B (3) ◽  
pp. 500-506
Author(s):  
Hollie J. Leonard ◽  
Nicholas E. Ohly
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Leg Length ◽  
Matched Group ◽  
Length Discrepancy ◽  
Superior Approach

Aims The purpose of this study was to compare the clinical, radiological, and patient-reported outcome measures (PROMs) in the first 100 consecutive patients undergoing total hip arthroplasty (THA) via a direct superior approach (DSA) with a matched group of patients undergoing THA by the same surgeon, using a posterolateral approach (PLA). Methods This was a retrospective single surgeon study comparing the first 100 consecutive DSA THA patients with a matched group of patients using a standard PLA. Case notes were examined for patient demographics, length of hospital stay, operating time, intra- and postoperative complications, pain score, satisfaction score, and Oxford Hip Score (OHS). Leg length discrepancy and component positioning were measured from postoperative plain radiographs. Results The DSA patients had a shorter length of hospital stay (mean 2.09 days (SD 1.20) DSA vs 2.74 days (SD 1.17) PLA; p < 0.001) and shorter time to discharge from the inpatient physiotherapy teams (mean 1.44 days (SD 1.17) DSA vs 1.93 days (SD 0.96) PLA; p < 0.001). There were no differences in operating time (p = 0.505), pain levels up to postoperative day 1 (p = 0.106 to p =0.242), OHS (p = 0.594 to p = 0.815), satisfaction levels (p = 0.066 to p = 0.299), stem alignment (p = 0.240), acetabular component inclination (p < 0.001) and anteversion (p < 0.001), or leg length discrepancy (p = 0.134). Conclusion While the DSA appears safe and was not associated with a significant difference in PROMs, radiological findings, or intraoperative or postoperative complications, a randomized controlled trial with functional outcomes in the postoperative phase is needed to evaluate this surgical approach formally. Cite this article: Bone Joint J 2021;103-B(3):500–506.

Decreasing Length of Hospital Stay and Postoperative Complications After Primary Total Hip Arthroplasty: A Decade Analysis From 2006 to 2016

2019 ◽  
Vol 34 (3) ◽  
pp. 422-425 ◽  
Author(s):  
Matthew J. Grosso ◽  
Alexander L. Neuwirth ◽  
Venkat Boddapati ◽  
Roshan P. Shah ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Length Of Hospital Stay ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Changes in patient-perceived leg length discrepancy following total hip arthroplasty

2021 ◽  
Author(s):  
Kentaro Iwakiri ◽  
Yoichi Ohta ◽  
Takashi Fujii ◽  
Yukihide Minoda ◽  
Akio Kobayashi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy

scholarly journals Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Tomoko Tetsunaga ◽  
Kazuo Fujiwara ◽  
Hirosuke Endo ◽  
Toshifumi Ozaki
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Total Hip Arthroplasty ◽  
Combination Therapy ◽  
Hospital Stay ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Length Of Hospital Stay

Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB), local infiltration analgesia (LIA), and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA). The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years). Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS) for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS). Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty

2019 ◽  
pp. 112070001988933 ◽  
Author(s):  
Babar Kayani ◽  
Sujith Konan ◽  
Sumon S Huq ◽  
Mazin S Ibrahim ◽  
Atif Ayuob ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Robotic Arm ◽  
Surgical Team ◽  
Leg Length ◽  
Acetabular Cup ◽  
Confidence Levels ◽  
Length Discrepancy ◽  
Cup Positioning

Background: Robotic-arm assisted surgery aims to reduce manual errors and improve the accuracy of implant positioning and orientation during total hip arthroplasty (THA). The objective of this study was to assess the surgical team’s learning curve for robotic-arm assisted acetabular cup positioning during THA. Methods: This prospective cohort study included 100 patients with symptomatic hip osteoarthritis undergoing primary total THA performed by a single surgeon. This included 50 patients receiving conventional manual THA and 50 patients undergoing robotic-arm assisted acetabular cup positioning during THA. Independent observers recorded surrogate markers of the learning curve including operative times, confidence levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy in restoring native hip biomechanics, acetabular cup positioning, leg-length discrepancy, and complications within 90 days of surgery. Results: Cumulative summation (CUSUM) analysis revealed robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for achieving operative times ( p < 0.001) and surgical team confidence levels ( p < 0.001) comparable to conventional manual THA. There was no learning curve of robotic-arm assisted THA for accuracy of achieving the planned horizontal ( p = 0.83) and vertical ( p = 0.71) centres of rotation, combined offset ( p = 0.67), cup inclination ( p = 0.68), cup anteversion ( p = 0.72), and correction of leg-length discrepancy ( p = 0.61). There was no difference in postoperative complications between the two treatment groups. Conclusions: Integration of robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for operative times and surgical team confidence levels but there was no learning curve effect for accuracy in restoring native hip biomechanics or achieving planned acetabular cup positioning and orientation.

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