Recovery Outcomes in Patients Having Total Hip Arthroplasty Via the Posterolateral Approach Did Not Differ for No Hip Precautions Vs. Standard Hip Precautions

2020 ◽  
Vol 102 (4) ◽  
pp. 341
Author(s):  
Benjamin F. Ricciardi
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterolateral Approach ◽  
Total Hip ◽  
Hip Precautions

scholarly journals Is convention hip precaution necessary after total hip arthroplasty?

2021 ◽  
Vol 28 ◽  
pp. 221049172110068
Author(s):  
Vincent WK Chan ◽  
MT Chan ◽  
PK Chan ◽  
CH Yan ◽  
KY Chiu
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Rotation ◽  
Hip Arthroplasty ◽  
Posterolateral Approach ◽  
Health Perceptions ◽  
P Value ◽  
Revision Thas ◽  
Total Hip ◽  
Hip Flexion ◽  
Hip Precautions

Background: Dislocation is one of the most common causes of revision after total hip arthroplasty (THA). Standard hip precautions are thought to enhance soft-tissue healing and reduce dislocations. However, lifestyle restrictions affect a patient’s rehabilitation, quality of life (QOL), and satisfactions. We aim to compare conventional (CP) and minimal hip precautions (MP) after THA. Methods: Retrospective review of prospectively collected data in posterolateral approach THA. Chief surgeon assigns patients to CP or MP group. CP group had to sleep supine, used elevated toilet seats and chairs, avoid hip flexion greater than 90°, and no internal rotation or adduction for 6 weeks. MP group had no restrictions in hip movements, except for the combined flexion, adduction and internal rotation. All had a minimum 1-year follow-up. The number of dislocations, length of stay (LOS), time to independent toileting, Harris Hip Scores, QOL, and health perceptions, assessed by EuroQol 5D-5L, was compared between CP and MP groups. Results: Fifty-five THAs were included. CP group consisted of 17 primary and 12 revision THAs; MP group consisted of 21 primary and 5 revision THAs. There were two dislocations and both are revisions in CP group. Overall rate of dislocation was 6.9% in CP group and no dislocation in MP group (p-value > 0.05). MP group had shorter LOS (12 vs 19 days, p-value 0.04), higher EQ5D-5L health perception scores at 1-year (81.7 vs 70.9, p-value 0.01). Conclusion: MP group had shorter LOS and better health perceptions 1-year after THA with no increase in dislocation rates.

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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Taku Ukai ◽  
Goro Ebihara ◽  
Masahiko Watanabe
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Posterolateral Approach ◽  
Level Of Evidence ◽  
Total Hip ◽  
Hip Flexion ◽  
Primary Total Hip Arthroplasty

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.

scholarly journals Postero-posterolateral approach in total hip arthroplasty

2020 ◽  
Vol 44 (12) ◽  
pp. 2577-2585
Author(s):  
Mokrane Ait Mokhtar
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Average Length ◽  
Surgical Techniques ◽  
Posterolateral Approach ◽  
Anatomical Landmarks ◽  
Rehabilitation Centre ◽  
Dual Mobility ◽  
Total Hip ◽  
The Stability

Abstract Introduction Evolving surgical techniques in total hip arthroplasty (THA) have sought to make the surgical procedures safer. This requires having highly reproducible incision landmarks and simplifying the procedures. The postero-posterolateral approach, a very posterior incision in the hip, meets those requirements. However, this has not helped to reduce the post-operative dislocation rate. The aim of this study was to assess the relevance of combining the postero-posterolateral approach and next-generation dual mobility cups (DMC) in terms of dislocation risk. Materials and methods One hundred and fifty-eight THA were performed consecutively using the postero-posterolateral approach on 150 patients, by a single surgeon, over a 49-month period (November 2010 to December 2014). All acetabular implants were impacted. Results Average length of the incision was 7 cm (6 to 9 cm). Mean duration of the surgical procedure was 75 minutes (40 to 100). Mean blood loss was estimated at 210 cc (25 to 410 cc). All patients could walk with assistance the day before transferring to a rehabilitation centre. There was one posterior dislocation (0.63%), without recurrence. Conclusion The straightforwardness and reproducibility of the anatomical landmarks used for the postero-posterolateral approach, added to the stability of the dual mobility cup, result in a safe combination in the therapeutic THA arsenal.

scholarly journals Recall and patient perceptions of hip precautions 6 weeks after total hip arthroplasty

2017 ◽  
Vol 88 (5) ◽  
pp. 496-499 ◽  
Author(s):  
George R H Lee ◽  
James R Berstock ◽  
Michael R Whitehouse ◽  
Ashley W Blom
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Perceptions ◽  
Total Hip ◽  
Hip Precautions

scholarly journals Bilateral simultaneous total hip arthroplasty: comparison of treatment outcome between the direct anterior approach and the posterolateral approach

2019 ◽  
Author(s):  
Shuo Feng ◽  
Ning Jian Sun ◽  
Yu Zhang ◽  
Ye Zhang ◽  
Yang Xiang Chen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Operation Time ◽  
Direct Anterior Approach ◽  
Posterolateral Approach ◽  
Joint Function ◽  
Total Hip ◽  
Postoperative Drainage

Abstract Background There are many surgical approaches for total hip arthroplasty. In recent years, direct anterior approach (DAA) has been highly praised by many scholars, and it has been widely reported that it has a good curative effect, such as fast recovery. Whether the surgical results and patient satisfaction can reach or exceed the traditional posterolateral approach has been controversial. We hypothesized that the treatment outcome of the direct anterior approach (DAA) approach is superior to the traditional posterolateral approach (PLA). Methods From January 2015 to April 2017, 20 patients (40 hips) were randomly divided into posterolateral approach (PLA) group and direct anterior approach (DAA) group. Record the operation time on both sides, postoperative drainage, prosthesis position, and complications, the functional recovery of hip joint was evaluated by D'Aubigne-Postel score, and the postoperative pain was evaluated by VAS score. Gait parameters were measured before surgery and at 3 and 6 months after surgery, and the patients were asked which side they preferred subjectively after surgery. Results When compared with the PLA group, the DAA group had a shorter incision length (11.4 vs 14.72 cm, P<0.001), shorter intraoperative blood loss (184.05vs 219.00 mL, P<0.001), shorter postoperative drainage volume (105.35 vs 154.10 mL, P<0.001), and lower VAS scores. However, the PLA had shorter operative times (82.20 vs 67.3 min, P<0.001). There was no significant difference in acetabular inclination (39.72 vs 40.92 °, P=0.069), and acetabular anteversion (17.41 vs 17.69°, P=0.663) between the two groups. Joint function recovery: The D'Aubigne-Postel scores of the hip joints in the DAA group vs PLA group at 1, 3, and 6 months after surgery were (8.2, 11.5, 16.5) vs (7.65, 11.45, 16.9). The difference in the 1, 3month was statistically significant (P=0.012, P=0.038), however, this difference disappeared in the 6th month(P=0.072). Conclusions Compared with the PLA, the DAA has the advantages of shorter operation time, smaller incision, less bleeding, less pain, better gait performance and faster recovery of joint function, but patients subjectively preferred the traditional PLA.

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

2017 ◽  
Vol 32 (10) ◽  
pp. 3141-3146 ◽  
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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