Approaches for Primary Total Hip Replacement

Ilchmann, Thomas

doi:10.5301/hipint.5000163

Cited by 20 publications

(14 citation statements)

References 24 publications

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“…The minimally invasive approaches are divided into two groups: "muscle-sparing" and "mini-incision" approaches. Over the last decades, several minimally invasive approaches and techniques have been introduced [20][21][22][23][24][25][26][27][28][29][30]. In general, there is no consensus in literature regarding a superiority of minimally invasive approaches compared to conventional approaches [31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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Background It remains uncertain if the new SuperPATH approach benefits patients in artificial hip joint replacement. We conducted a systematic review and meta-analysis of randomized controlled trials to compare the short-term outcome of SuperPATH approach and conventional approaches in hip joint replacement. Methods A systematic literature search up to April 2020 was performed to identify randomized controlled trials comparing SuperPATH with conventional approaches in hip joint replacement. We measured surgical, functional, and radiological outcomes. Mean differences or odds ratios with 95% confidence intervals were calculated and pooled using random effects models and the Hartung-Knapp-Sidik-Jonkman method. Results A total of 12 RCTs involving 726 patients met the inclusion criteria, one trial with a level I evidence, 11 trials with level II evidence. The overall meta-analysis showed that SuperPATH approach reduced incision length (MD = − 4.84, 95% CI − 7.04 to − 2.64, p < 0.01), pain VAS 7 day postoperatively (MD = − 1.39, 95% CI − 2.57 to − 0.21, p = 0.03), and HHS 7 day postoperatively (MD = 10.24, 95% CI 0.27 to 20.21, p = 0.05). The two approaches did not differ in acetabular cup positioning angles, intra- and postoperative blood loss, hospitalization period, and postoperative complications. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Long-term outcomes of SuperPATH approach need to be investigated.

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Section: Introductionmentioning

confidence: 99%

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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“…Each has been proven to be successful and each has its own advantages. 3 In our experience, we have noted earlier functional recovery, improved hip strength and gait range-of-motion, and more accurate and precise placement of the acetabular cup component in DAA compared to PA THA.…”

Section: Muscle Strengthmentioning

confidence: 86%

“…1,2 One area of investigation has been the use of various surgical approaches, including minimally invasive surgery. [3][4][5] The direct anterior approach (DAA) has gained popularity among patients and surgeons and is considered a minimally invasive technique, as it takes advantage of a true intermuscular plane interval. 6 Originally, the senior author (JAR) had been trained with the conventional posterior approach (PA) for THA, but transitioned to DAA over the years.…”

Section: Introductionmentioning

confidence: 99%

The mini-anterior approach: Optimizes total hip arthroplasty outcome—Affirms

Jahng

Rodríguez

2015

Seminars in Arthroplasty

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“…Whilst national joint registries are now collecting data regarding surgical approach and patient-reported outcome measures, to our knowledge, there is no high-level study directly comparing the three aforementioned approaches and there is a paucity of follow-up data regarding the approaches for total hip arthroplasty [ 52 ]. This study aims to address this current void in the orthopaedic literature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcome measures and complication rates following three different approaches for primary total hip arthroplasty: a pragmatic randomised controlled trial

Talia

Coetzee

Tirosh

et al. 2018

Trials

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BackgroundTotal hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty.Methods/designThis is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre. It is a pragmatic, parallel three-arm, randomised controlled trial. Sample size will be 243 participants (81 in each group). Randomisation will be secure, web-based and managed by an independent statistician. Patients and research team will be blinded pre-operatively, but not post-operatively.Intervention will be either direct anterior, lateral or posterior approach for total hip arthroplasty, and the three arms will be directly compared. Participants will be aged over 18 years, able to provide informed consent and recruited from our outpatients. Patients who are having revision surgery or have indications for hip replacement other than osteoarthritis (i.e., fracture, malignancy, development dysplasia) will be excluded from the trial.The Oxford Hip Score will be determined for patients pre-operatively and 6 weeks, 6, 12 and 24 months post-operatively. The Oxford Hip Score at 24 months will be the primary outcome measure. Secondary outcome measures will be dislocation, infection, intraoperative and peri-prosthetic fracture rate, length of hospital stay and pain level, reported using a visual analogue scale.DiscussionMany studies have evaluated approaches for total hip arthroplasty and arthroplasty registries worldwide are now collecting this data. However no study to date has compared these three common approaches directly in a randomised fashion. No trial has used patient-reported outcome measures to evaluate success. This pragmatic study aims to identify differences in patient perception of total hip arthroplasty depending on surgical approach.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12617000272392. Registered on 22 February 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-017-2368-7) contains supplementary material, which is available to authorized users.

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Approaches for Primary Total Hip Replacement

Cited by 20 publications

References 24 publications

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

The mini-anterior approach: Optimizes total hip arthroplasty outcome—Affirms

Comparison of outcome measures and complication rates following three different approaches for primary total hip arthroplasty: a pragmatic randomised controlled trial

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