scholarly journals A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

2013 ◽  
Vol 5 (3) ◽  
pp. 19 ◽  
Author(s):  
Stefan Landgraeber ◽  
Henning Quitmann ◽  
Sebastian Güth ◽  
Marcel Haversath ◽  
Wojciech Kowalczyk ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hip Replacement ◽  
Postoperative Outcome ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
Anterolateral Approach ◽  
Total Hip ◽  
Duration Of Surgery ◽  
Minimally Invasive Anterolateral Approach

There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

SHALL IT BE BETTER, AS AN APPROACH FOR THR, POSTERIORLY OR LATERALLY; A CLINICO-FUNCTIONAL AND GAIT ANALYTICAL OUTCOME ANALYSIS, IN A PROSPECTIVE STUDY, IN THE SOUTH-INDIAN POPULATION.

2021 ◽  
pp. 71-75
Author(s):  
Arun Kumar C ◽  
Ganashree S ◽  
Arivoli S ◽  
Aswath C A ◽  
Rakesh Kumar B ◽  
...  
Keyword(s):  
Prospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
South Indian Population ◽  
Total Hip ◽  
South Indian

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.

scholarly journals Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Shuai Mao ◽  
Baomin Chen ◽  
Ying Zhu ◽  
Liang Qian ◽  
Jinluan Lin ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Total Hip ◽  
Uncemented Total Hip Replacement

Abstract Background Cemented or uncemented total hip replacement (CTR or UTR) for femoral neck fractures (AO/OTA type 31B/C) is a relatively common procedure in elderly individuals. The recent literature is limited regarding long-term outcomes following CTR versus UTR in the Asian population. Methods Using our institutional database, we performed long-term outcome analysis on 268 patients with femoral neck fractures (AO/OTA type 31B/C) who had undergone a primary UTR or CTR (CTR: n = 132, mean age, 67.43 ± 6.51 years; UTR: n = 136, mean age, 67.65 ± 6.13 years) during 2007–2014, and these patients were followed until 2019. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary endpoint was the Harris hip score (HHS); the secondary endpoint was the incidence of orthopaedic complications. Results The mean follow-up time was 62.5 months (range, 50.1–76.1 months). At the final follow-up, the HHS was 79.39 ± 16.92 vs 74.18 ± 17.55 (CTR vs UTR, respectively, p = 0.011). Between-group significant differences were observed regarding the incidence of prosthesis revision, prosthesis loosening, and periprosthetic fracture (7.6% [95% CI, 6.4–8.2] for CTR vs 16.9% [95% CI, 14.7–17.3] for UTR, p = 0.020; 9.8% [95% CI, 8.3–10.7] for CTR vs 19.9% [95% CI, 18.2–20.9] for UTR, p = 0.022; 5.3% [95% CI, 4.4–6.7] for CTR vs 13.2% [95% CI, 12.1–13.8] for UTR, p = 0.026, respectively). Conclusion CTR showed superiority to UTR by improving the HHS and decreasing the incidence of orthopaedic complications. Our findings need to be confirmed in a prospective, randomized controlled study to verify whether they can be applicable to a broader population.

Outcomes of Total Hip Replacement in Limbs Affected by Poliomyelitis

2016 ◽  
Vol 27 (2) ◽  
pp. 198-204
Author(s):  
Cesare Faldini ◽  
Marcello De Fine ◽  
Alberto Di Martino ◽  
Daniele Fabbri ◽  
Raffaele Borghi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Replacements ◽  
Hip Diseases

Introduction The outcomes of total hip replacement in patients suffering from residual poliomyelitis are poorly covered in the literature. In this retrospective study we posed the question of whether total hip replacement performed for degenerative hip diseases in limbs with residual poliomyelitis could determine satisfactory mid-term clinical and radiographic results, with a reasonable complication rate. Methods A retrospective study was carried out to assess the results of 14 total hip replacements performed on 14 patients with residual poliomyelitis on the involved limb from June 1999 to September 2011. Average age at the time of surgery was 51 years (range 26-66 years). Mean duration of follow-up was 92 months (range 52-156 months). Surgery was performed through a direct lateral approach on all hips. All but one were cementless implants. Results 2 implants failed, 1 due to traumatic acetabular fracture 6 days after surgery, and 1 due to aseptic cup loosening 13 years after surgery. Surgery was uneventful in all patients except 1 (7%), who experienced a transient sensory sciatic nerve palsy. At the latest follow up Harris Hip Score was 83.3 (range 72-91) with a marked improvement when compared to preoperative score (average 52, range 32-78). No dislocations had occurred. Conclusions Total hip replacement can be considered a feasible option for hip osteoarthritis in patients with limbs affected by residual poliomyelitis. Longer follow-up studies are needed to assess the effectiveness of unconstrained total hip replacement in polio patients.

scholarly journals Standard transgluteal versus minimal invasive anterior approach in hip arthroplasty: a prospective, consecutive cohort study

2013 ◽  
Vol 5 (4) ◽  
pp. 31 ◽  
Author(s):  
Thomas Ilchmann ◽  
Silke Gersbach ◽  
Lukas Zwicky ◽  
Martin Clauss
Keyword(s):  
Minimally Invasive ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Clinical Results ◽  
Lateral Approach ◽  
Minimal Invasive ◽  
Harris Hip Score ◽  
Duration Of Surgery ◽  
One Year ◽  
Continuous Use

A minimally invasive anterior approach (MIS) was compared to a standard lateral approach in primary total hip arthroplasty. Clinical and radiological outcomes were analyzed 6 weeks, 12 weeks, one year and two years after surgery. The duration of surgery was longer, mobility one week after surgery was better and time of hospitalization was shorter for minimally invasive-treated patients. They had less pain during movement, limping, better Harris Hip Score and satisfaction after 6 weeks, which remained after 12 weeks and 1 year, but not after two years. There were two deep infections in the MIS group. Radiological results were not affected. The infections might be a point of concern, but there were no other disadvantages of the MIS approach. In fact, early rehabilitation was facilitated and clinical results were improved. Our results encourage the continuous use of the MIS anterior approach instead of the lateral approach.

scholarly journals A new anterolateral surgical approach for total hip replacement

Joints ◽  
2016 ◽  
Vol 04 (03) ◽  
pp. 148-152
Author(s):  
Giovanni Grano ◽  
Maria Pavlidou ◽  
Alberto Todesco ◽  
Augusto Palermo ◽  
Luigi Molfetta
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Case Series ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Anterolateral Approach ◽  
X Rays ◽  
Level Of Evidence ◽  
Total Hip

Purpose: the purpose of the present paper is to present the short-term results of a “detachment-free” (DF) anterolateral approach for primary total hip replacement (THR) performed in a large series of patients. Methods: two hundred patients submitted to primary THR were retrospectively reviewed for the present study. In all cases, the surgery was performed using a minimally invasive DF anterolateral approach, which entails no disconnection of tendons and no muscle damage. The study population consisted of 96 men (48%) and 104 women (52%), with an average age of 69.4 years (range 38-75). Clinical and radiographic follow-up was performed after 12 months. Results: the clinical results, evaluated using the Harris Hip Score, were excellent in 95% of the cases and good in 5%; no cases had fair or poor results. X-rays taken at 3, 6 and 12 months after surgery did not show heterotopic ossification, mobilization of the prosthetic components, or hip dislocation. No infections, deep vein thrombosis, or failure of the gluteal muscles were reported. Conclusions: the DF anterolateral approach for THR proved safe and provided effective results at shortterm follow-up. Level of evidence: Level IV, therapeutic case series.

Minimally invasive lateral approach in total hip replacement: a prospective randomised study

2010 ◽  
Vol 54 (1) ◽  
pp. 27-33
Author(s):  
J.R. Varela-Egocheaga ◽  
M.A. Suárez-Suárez ◽  
M. Fernández-Villán ◽  
V. González-Sastre ◽  
J.R. Varela-Gómez ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Lateral Approach ◽  
Randomised Study ◽  
Total Hip ◽  
Prospective Randomised Study

Low pelvic incidence is a risk factor for intraoperative complications in minimally invasive anterolateral approach for total hip arthroplasty

2020 ◽  
pp. 112070002095352
Author(s):  
Youngwoo Kim ◽  
Aidin Eslam Pour ◽  
Jean Yves Lazennec
Keyword(s):  
Total Hip Arthroplasty ◽  
Minimally Invasive ◽  
Hip Arthroplasty ◽  
Pelvic Incidence ◽  
Intraoperative Complications ◽  
Femoral Fractures ◽  
Anterolateral Approach ◽  
Femoral Access ◽  
Total Hip ◽  
Minimally Invasive Anterolateral Approach

Background: Minimally invasive anterolateral approach (ALA) has gained popularity in recent years as better postoperative functional recovery and lower risk of postoperative dislocation are claimed. However, difficulties for femur exposure and intraoperative complications during femoral canal preparation and component placement have been reported. This study analyses the effect of anatomical factors on difficulties for femoral access and intraoperative complications with a modified minimally invasive ALA. Material and methods: 310 consecutive patients who had primary unilateral total hip arthroplasty (THA) by single surgeon using same approach and technique, and being suitable for EOS were included. All patients underwent pre- and postoperative standing and sitting full-body EOS acquisitions and pelvic and femoral parameters were measured. All intra- and postoperative complications for femoral preparation and implantation were assessed. Intraoperative complications included femoral fractures and difficulties for femoral exposure. Results: 10 patients (3.2%) had intraoperative femoral fractures (2 greater trochanter, 8 calcar). Difficult access to the proximal femur was reported for 10 other patients (3.2%). Patients with intraoperative complications presented a significantly lower pelvic incidence (PI) than patients without intraoperative complications (mean PI: 39.4° vs. 56.9°, p < 0.001). Conclusions: The pelvic incidence can be useful to detect anatomically less favourable patients for THA implantation using ALA.

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