Acetabular Abduction and Dislocations in Direct Anterior vs Posterior Total Hip Arthroplasty: A Retrospective, Matched Cohort Study

Tripuraneni, Krishna R.; Munson, Natalie R.; Archibeck, Michael J.; Carothers, Joshua T.

doi:10.1016/j.arth.2016.03.008

Cited by 46 publications

(48 citation statements)

References 27 publications

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“…9 While these findings have been supported elsewhere in the literature, 14,15 younger patients may have shorter LOS after THA in general. 16,17 There has been no evidence to suggest long-term clinical benefits of anterior compared to posterior-THA regardless of age, 9,18,19,20,21 which is also consistent with our study, as there was no difference between groups with respect to postoperative complications.…”

Section: Discussionsupporting

confidence: 86%

Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach

Luthringer¹,

Novikov²,

Gabor³

et al.

EPiC Series in Health Sciences

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PURPOSE: Indications for total hip arthroplasty (THA) are expanding to include increasingly younger patients, yet limited outcomes research has focused on this population. This study compares outcomes between the anterior and posterior approach, as well as between conventional and technology-assisted THA in patients under 35-years of age.METHODS: Retrospective analysis of 139 primary THAs in 125 patients younger than 35-years old was conducted. Patients were divided into two cohorts: (1) anterior-THA and (2) posterior-THA. A posterior-THA sub-group analysis was performed to compare: (1) technology-assisted THA (tech-THA) versus (2) conventional-THA (con-THA). Demographics, perioperative data, radiographic and clinical outcomes were analyzed using Chi squared and unpaired student t-tests for categorical and continuous variables, respectively.RESULTS: Of the 139 cases performed, 40 were anterior-THA and 99 were posterior-THA. The anterior-THA cohort had shorter mean surgical time (95.0±25.7 vs. 118.3±43.3 minutes; p<0.01), shorter hospital admissions (1.9±1.4 vs. 2.7±1.2 days; p<0.01), and lower estimated blood loss (343.4±164.1 vs. 438.0±272.8 mL; p<0.01) compared to the posterior-THA cohort. There were no significant differences in component positioning, limb length discrepancy, clinical outcomes or postoperative complications between cohorts. In the sub-group analysis, cup placement within Lewinnek’s Safe Zone was achieved in 78% of tech-THA versus 49% of con-THA (p<0.01). Need for revision THA was significantly higher among the con-THA group (9.4% vs. 0%; p<0.01).CONCLUSION: There is no significant difference in outcomes between anterior- and posterior-THA among patients under 35-years of age, however, the anterior approach may promote earlier hospital discharge. Technological-assistance can improve component positioning and may reduce the rate of revision for posterior-THA in patients under 35-years old.

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Section: Discussionsupporting

confidence: 86%

Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach

Luthringer¹,

Novikov²,

Gabor³

et al.

EPiC Series in Health Sciences

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“…Conversely, PA has generally been associated with higher dislocation rates of 1.7%–5.3% 404142. Although recent literature has demonstrated improved stability with posterior capsular repairs 42434445. Randomized prospective data on dislocations is lacking, but several meta analyses and large retrospective comparative studies have demonstrated stability superiority with the anterior based approaches versus PA 344647484950.…”

Section: Discussionmentioning

confidence: 99%

Surgical Approaches for Total Hip Arthroplasty

Moretti

Post

2017

IJOO

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Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches. A review of outcomes and complications for each approach are also provided. Each approach has its own unique advantages and disadvantages, but all can be safely and successful utilized for THA. Strong, convincing, high-quality studies comparing the different approaches are lacking at this time. Surgeons are therefore recommended to choose whichever approach they are most comfortable and experienced using. Though not described here, THA can also be done using the anterolateral approach (also known as the Watson Jones approach) as well as the two-incision approach. In addition, recently, some surgeons are utilizing the so-called direct superior approach for THA. While these approaches are far less commonly utilized, they are recognized as viable alternatives to traditional approaches.

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“…Biz aseatbuler kap pozisyonlandı-rılmasında Lewinnek'in güvenli zonlarını baz aldık (8) . Özellikle asetabuler abdüksiyon açısının polietilen aşınmasındaki en önemli prediktif faktör olduğu gös-terilmiştir (12) .…”

Section: Discussionunclassified

“…Özellikle asetabuler komponentin abdüksiyon ve anteversiyon açılarının doğru ayarlanması oldukça önemlidir (8) . Bununla beraber, cerrahi yaklaşımın komponent dizilimini etkilediğini gösteren çalışmalar bulunmaktadır (9) .…”

Section: Introductionunclassified

Effect of Two Different Approaches by the Same Surgeon on Component Alignment in Total Hip Arthroplasty

Dedeoğlu¹,

İmren²,

Çabuk³

et al. 2017

Okmeydani Medical Journal

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Acetabular Abduction and Dislocations in Direct Anterior vs Posterior Total Hip Arthroplasty: A Retrospective, Matched Cohort Study

Cited by 46 publications

References 27 publications

Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach

Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach

Surgical Approaches for Total Hip Arthroplasty

Effect of Two Different Approaches by the Same Surgeon on Component Alignment in Total Hip Arthroplasty

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