A Comparative Evaluation of Primary Total Hip Arthroplasty via Lateral and Posterolateral Approaches

Gharanizade, Kaveh; Heris, Hossein Karimi; Abolghasemian, Mansour; Joudi, Samad; Panahy, Payam Hassany Shariat; Yoosefzadeh, Amin

doi:10.17795/soj-3901

Cited by 3 publications

(4 citation statements)

References 14 publications

(18 reference statements)

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“…These outcomes slightly lagged behind another study where the initial scores were lower but reached near-perfect scores at the six-month follow-up (20). Our study noted a dislocation rate of 4.1%, comparable to a previous study that observed a dislocation rate of approximately 3% in a larger cohort (21). Moreover, the limb length discrepancy significantly decreased post-operatively, aligning with literature suggesting that the lateral approach may confer a lower risk of dislocation (22,23).…”

Section: Discussionsupporting

confidence: 78%

Functional and Clinical outcomes of total hip replacement surgery via Lateral approach

Rehman,

Qayyum,

Khan

et al. 2024

JHRR

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Background: Total hip arthroplasty (THA) is a critical surgical intervention for patients with severe hip dysfunction primarily due to conditions such as osteoarthritis, trauma, and other degenerative diseases. The choice of surgical approach can significantly influence the outcomes of the procedure, including postoperative recovery, pain management, and functional mobility. Objective: This study aims to evaluate the clinical and functional outcomes of the lateral approach in total hip replacement, comparing its efficacy and safety with other surgical techniques. Methods: A retrospective cohort study was conducted at a single medical teaching institution, involving 74 patients who underwent total hip replacement using the lateral approach between January 2022 and December 2023. Data were collected on patient demographics, surgical details, and postoperative outcomes. Key measures included the Harris Hip Score (HHS), rates of postoperative pain, limb length discrepancy (LLD), and complications such as dislocation and infection. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 25, with a significance threshold set at P < 0.05. Results: The study population had an equal distribution of male and female patients, with an average age of 57.20 years (SD ± 14.68). Trauma was the most common indication for surgery (67.6%), followed by osteoarthritis (18.9%) and avascular necrosis (9.5%). Postoperative evaluation showed that 62.26% of patients achieved an 'excellent' HHS at two weeks, while 28.38% were rated as 'good'. The overall complication rate was low, with dislocation occurring in 4.1% of cases. Pain was reported in 12.2% of patients post-surgery. Conclusion: The lateral approach for total hip arthroplasty provides effective pain relief and functional recovery with a low complication rate. This study supports the continued use of the lateral approach as a viable option for hip replacement surgery, showing comparable or superior outcomes to other surgical approaches.

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Section: Discussionsupporting

confidence: 78%

Functional and Clinical outcomes of total hip replacement surgery via Lateral approach

Rehman,

Qayyum,

Khan

et al. 2024

JHRR

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“…Many of the previous studies reported similar perioperative bleeding volume between the two surgical approaches. [22][23]27,28] However, Weale et al showed a significantly lower mean perioperative blood loss in PA compared to LA (599 cc vs. 768 cc). [19] The overall perioperative bleeding volume following THA was found to be similar in both surgical approaches in a systematic review and meta-analysis.…”

Section: Discussionmentioning

confidence: 98%

“…Most of the studies in the literature found post-operative blood transfusion to be similar among PA and LA. [21,23,27,29] However, Hart et al found that the proportion of patients requiring post-operative allogenic transfusion is significantly higher in LA than PA (11.55% vs. PA; 6.8%). [18] Our study revealed a relatively low complication rate following THA through PA than LA (7.0% vs. 12.9%).…”

Section: Discussionmentioning

confidence: 99%

Post-operative clinical outcomes and complications of posterior versus lateral approach for primary total hip arthroplasty: A retrospective cohort study

Halawani

Ghaddaf

Alomari

et al. 2022

JMSR

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Objectives: Total hip arthroplasty (THA) is considered one of the therapeutic procedures frequently performed in orthopedic surgery. It is believed that the surgical approach could influence the clinical outcomes following THA. We performed a retrospective cohort study to compare the postoperative clinical outcomes and complications between the posterior approach (PA) and the lateral approach (LA) for primary THA. Methods: We enrolled patients who underwent primary THA through PA or LA. We sought to evaluate the postoperative complications including the need for intra- or postoperative blood transfusion, dislocation rate, and venous thromboembolism events, and the clinical outcomes, including length of hospital stay, operative time, and perioperative blood loss. Results: A total of 211 patients (71 patients in PA vs. 140 patients in LA) were deemed eligible to be included in this study. There was no significant difference between PA and LA in post-operative clinical outcomes concerning operative time, and perioperative blood loss except for the length of hospital stay (PA median = 6.0 days vs. LA median = 9.0 days; P < 0.001) patients. After adjustment for the potential confounders, the length of hospital stay was found to be similar between the two groups (P = 0.06). Similarly, no difference was found between PA and LA in post-operative complications concerning the need for intra-operative blood transfusion, dislocation rate, and venous thromboembolism events except for the need for postoperative blood transfusion (RR = 1.82, 95% CI 1.16–2.87), which continued to be significantly higher in PA even after adjustment for the potential confounders (P ≤ 0.01). Conclusion: PA and LA herald similar outcomes for patients undergoing primary THA concerning the postoperative clinical outcomes and complications except for the need for post-operative blood transfusion.

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“…Another study by Gharanizade et al, which examined 134 patients who underwent primary hip arthroplasty, found that both the lateral and posterolateral approaches yielded similar results. Yet, disparities emerged regarding infections, DVT, proximal femur fractures, and limb length discrepancies (Gharanizade et al, 2016). The overarching conclusion was that both approaches facilitated effective pain reduction and restored function post-total hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Moore's (Posterior) Approach vs. Harding (Lateral) Approach in Total Hip Arthoplasty

RAZA,

MINHAS,

ALI

et al. 2023

Biol Clin Sci Res J

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The primary objective of this study was to conduct a comparative analysis between Moore's and Harding's approaches for total hip arthroplasty. A randomized controlled trial was undertaken at the esteemed Department of Orthopaedics, Mayo Hospital, Lahore, from 01-06-2020 to 30-06-2022. The study encompassed individuals of both genders, aged 40 years and above, undergoing total hip arthroplasty for various reasons. These participants were divided into two distinct groups: Group A received treatment through the lateral or Harding's approach, while Group B underwent the posterior or Moore's approach. A comprehensive assessment of diverse outcomes was performed. The total cohort for this study consisted of 60 cases, with each Group containing 30 cases. The average age of the participants was 63.57±9.11 years for Group A and 62.79±8.43 years for Group B, revealing no statistically significant difference (p=0.67) between the two groups. The mean duration of the surgical procedure exhibited variance, with Group A recording a time of 77.31±10.91 minutes and Group B with a shorter duration of 64.41±8.19 minutes (p=0.01). Interestingly, the incidence of recurrence displayed a noteworthy contrast between the approaches. The posterior approach yielded a significantly higher recurrence rate, observed in 9 cases (30%), as opposed to the lateral Group, which exhibited recurrence in 3 cases (10%) (p=0.01). Consequently, these findings conclude that the lateral approach boasts a substantial advantage in minimizing recurrence rates. Conversely, the posterior approach achieves a more efficient mean surgical duration. This investigation establishes the superiority of the lateral approach in reducing the recurrence rate while acknowledging the posterior approach's proficiency in achieving a shorter mean surgical duration. This study not only contributes to the advancement of surgical techniques but also provides valuable insights into clinical decision-making in the realm of total hip arthroplasty.

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A Comparative Evaluation of Primary Total Hip Arthroplasty via Lateral and Posterolateral Approaches

Cited by 3 publications

References 14 publications

Functional and Clinical outcomes of total hip replacement surgery via Lateral approach

Functional and Clinical outcomes of total hip replacement surgery via Lateral approach

Post-operative clinical outcomes and complications of posterior versus lateral approach for primary total hip arthroplasty: A retrospective cohort study

Comparison of Moore's (Posterior) Approach vs. Harding (Lateral) Approach in Total Hip Arthoplasty

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