Direct anterior versus anterolateral approach in one-stage supine total hip arthroplasty. Focused on nerve injury: A prospective, randomized, controlled trial

Takada, Ryohei; Jinno, Tetsuya; Miyatake, Kazumasa; Hirao, Masanobu; Kimura, Akimasa; Koga, Daisuke; Yagishita, Kazuyoshi; Okawa, Atsushi

doi:10.1016/j.jos.2018.05.005

Cited by 64 publications

(79 citation statements)

References 18 publications

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“…Hamilton et al 12 evaluated the use of implant positioning software with fluoroscopy in anterior THA in 200 patients and reported closer results to target but with longer operative and fluoroscopy time. Takada et al 15 compared direct anterior with anterolateral approaches in bilateral THA in 30 patients at a 1-year follow-up focusing on nerve injury and muscle atrophy measured on CT and MRI. They reported no differences in clinical outcomes despite significant differences in muscle atrophy and increased nerve injury with the anterior approach.…”

Section: Resultsmentioning

confidence: 99%

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

Matar

Platt

Board³

et al. 2020

JAAOS Glob Res Rev

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Aim: To provide an overview of randomized controlled trials (RCTs) in primary total hip arthroplasty summarizing the available high-quality evidence. Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), we searched the Cochrane Central Register of Controlled Trials (2020, Issue 1), Ovid MEDLINE, and Embase. We excluded nonrandomized trials, trials on neck of femur fractures or revision surgery, systematic reviews, and meta-analyses. Trials that met our inclusion criteria were assessed using a binary outcome measure of whether they reported statistically significant findings. These were then classified according to the intervention groups (surgical approach, fixation, and component design use, among others). Results: Three hundred twelve RCTs met the inclusion criteria and were included. The total number of patients in those 312 RCTs was 34,020. Sixty-one RCTs (19.5%) reported significant differences between the intervention and the control groups. The trials were grouped into surgical approach 72, fixation 7, cement 16, femoral stem 46, head sizes 5, cup design 18, polyethylene 25, bearing surfaces 30, metal-on-metal 30, resurfacing 20, navigation 15, robotics 3, surgical technique 12, and closure/drains/postoperative care 13 RCTs. Discussion: The evidence reviewed indicates that for the vast majority of patients, a standard conventional total hip arthroplasty with a surgical approach familiar to the surgeon using standard well-established components and highly cross-linked polyethylene leads to satisfactory clinical outcomes. This evidence also offers arthroplasty surgeons the flexibility to use the standard and cost-effective techniques and achieve comparable outcomes.

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Section: Resultsmentioning

confidence: 99%

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

Matar

Platt

Board³

et al. 2020

JAAOS Glob Res Rev

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“…Journal of Orthopaedics and Traumatology invasive, having low dislocation rates [9], and resulting in early recovery [10] because both approaches take advantage of the intermuscular plane [11][12][13][14]. Although DAA is associated with a lower visual analog scale (VAS) score, longer walking distance, and shorter hospital stay than the posterior approach, it is also associated with lateral femoral cutaneous nerve (LFCN) injury [15,16]. Previous studies have reported that 23-30% of patients who underwent THA via DAA experienced numbness of the lateral thigh [15,16].…”

Section: Open Accessmentioning

confidence: 99%

“…Although DAA is associated with a lower visual analog scale (VAS) score, longer walking distance, and shorter hospital stay than the posterior approach, it is also associated with lateral femoral cutaneous nerve (LFCN) injury [15,16]. Previous studies have reported that 23-30% of patients who underwent THA via DAA experienced numbness of the lateral thigh [15,16]. Compared with DAA, ALS rarely causes LFCN injury and can preserve the anterior capsule, iliofemoral ligament, and conjoint tendon.…”

Section: Open Accessmentioning

confidence: 99%

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

2021

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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.

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“…The direct anterior approach showed higher rates of superficial wound complications among both obese and nonobese patient groups. Compared with the direct anterior approach, the anterolateral approach was found to have a lower incidence of superior gluteal nerve injury in a recent prospective controlled study of 30 patients who underwent single-stage bilateral THA with use of the anterolateral approach on 1 side and the direct anterior approach on the other 51 .…”

Section: Direct Anterior Approachmentioning

confidence: 99%

What’s New in Hip Replacement

Glassman

2018

The Journal of Bone and Joint Surgery

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Direct anterior versus anterolateral approach in one-stage supine total hip arthroplasty. Focused on nerve injury: A prospective, randomized, controlled trial

Cited by 64 publications

References 18 publications

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

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

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