Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Miller, Larry E.; Gondusky, Joseph S; Bhattacharyya, Samir; Kamath, Atul F.; Boettner, Friedrich; Wright, John

doi:10.1016/j.arth.2017.11.011

Cited by 132 publications

(105 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 Our findings are also in agreement with a recent meta-analysis of prospective studies by Miller et al that found no statistical difference in complication rates between the two approaches. 36 We demonstrated no difference between approaches relating to the need for revision surgery secondary to infection, consistent with the 2011 metaanalysis by Smith 21 Considering this is the first study to evaluate outcomes based on approach in this young patient population, it is difficult to compare the results of the present study to the aforementioned published literature.…”

Section: Discussionsupporting

confidence: 77%

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

Novikov

Luthringer

Cizmic

et al. 2020

The Journal of Hip Surgery

View full text Add to dashboard Cite

Despite the increasing frequency of younger patients undergoing total hip arthroplasty (THA), very few, if any, studies report on postoperative outcomes that specifically compare the two most commonly used approaches in this age group. The purpose of our study is to assess whether surgical approach affects postoperative outcomes in THA patients younger than 35 years. A retrospective analysis of 115 patients younger than 35 years that underwent primary unilateral THA between January 2013 and April 2018 was conducted. Patients were divided into two cohorts: (1) patients that underwent THA utilizing the anterior approach and (2) patients that underwent THA utilizing the posterior approach. Subanalysis controlling for surgical case complexity and use of robotic assistance was performed. Radiographic analysis included measurement of perioperative leg length discrepancies. Of the total 115 patients, 37 were in the anterior THA cohort, and 78 were in the posterior THA cohort. All baseline patient characteristics were similar among both cohorts. Patients in the anterior THA cohort had shorter mean operative times (95 vs. 121 minutes; p < 0.01) and shorter mean hospital length of stay or LOS (1.9 vs. 2.8 days; p < 0.01). Leg length discrepancies, dislocation, revision, and all-cause postoperative complication rates were similar between both cohorts. When excluding complex cases and use of robotic assistance (anterior n = 36, posterior n = 39), there was no difference in operative time, LOS, or postoperative outcomes. Our study suggests that surgically complex patients were more likely to undergo posterior rather than anterior THA. When controlling for surgical complexity and use of robotic assistance, no difference between approach with respect to operative time, hospital LOS, dislocation, revision, and all-cause postoperative surgical complication rates in THA recipients under 35 years of age was found. The results suggest that the anterior and posterior approaches can be equally effective for the majority of young THA patients.

show abstract

Section: Discussionsupporting

confidence: 77%

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

Novikov

Luthringer

Cizmic

et al. 2020

The Journal of Hip Surgery

View full text Add to dashboard Cite

show abstract

“…Similarly, Maratt et al reported that no surgical approach has a compelling advantage over any other, including for dislocation risk [42]. Ultimately, the surgical approach for primary THA should be chosen according to the surgeon preference and experience as well as the preference and anatomy of the patient [43].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical characteristics and 10-year survival rates of revision hip arthroplasties among revision time groups

et al. 2021

View full text Add to dashboard Cite

Introduction: No significant regression has been reported in revision total hip arthroplasty (THA) rates despite substantial progress in implant technologies and surgical techniques. It is critical to investigate how patient demographics, THA indications, surgical techniques, types of implants, and other factors influence the frequency of early and late revision surgery. The main purpose of the present study was to evaluate the clinical characteristics and 10-year survival rates of revision hip arthroplasties among revision time groups. Material and methods: The clinical data of 396 patients who underwent revision hip arthroplasty between 2005 and 2011 were evaluated in this multi-centre study. Patients were assigned to one of four revision time groups based on the interval between the index hip arthroplasty and the revision surgery (< 2, 2-5, 5-10, and > 10 years). Results: There were significant differences among revision time groups in terms of aetiology for primary hip arthroplasty, indications for revision hip arthroplasty, and types of revision procedures. Patients with hip dysplasia more frequently received revision hip arthroplasty within two years in contrast to those with osteoarthritis. Revision hip arthroplasties due to periprosthetic infection and instability were conducted earlier compared to aseptic loosening. The overall 10-year survival rate of revision hip arthroplasty was 83.2%, and it was highest for the very early revisions (< 2 years). Conclusions: According to our results, early revision hip arthroplasty was found to be mostly dependent on surgery-related factors rather than demographic factors. On the other hand, we observed that survival rates of very early revision hip arthroplasties are higher than late revision hip arthroplasties.

show abstract

“…Many advantages are described in comparison to the other approaches mentioned at the beginning of this chapter. Patients treated with the minimal invasive approach suffer less pain and consume fewer narcotics [25,26]. This is usually explained by less soft-tissue damage while avoiding muscle splitting and detachment in comparison to the posterior or anterolateral approach.…”

Section: Outcomementioning

confidence: 99%

Anterior Primary Total Hip Arthroplasty

Bechler¹,

Springer²,

Boettner³

2018

Total Hip Replacement - An Overview

Self Cite

View full text Add to dashboard Cite

Total hip arthroplasty (THA) is the preferred treatment for end-stage osteoarthritis of the hip. The posterior, posterolateral, direct lateral, anterolateral, or the anterior approaches are the currently established surgical approaches for THA. Over the last decade, the anterior approach has gained increasing popularity. Its muscle-sparing nature and fluoroscopy-guided component positioning are the most important benefits. It has been suggested that postoperative recovery is facilitated by an anterior approach. Patients do not need to follow hip precautions, and can return to driving after 1 week. The anterior approach uses a muscle interval between the tensor fasciae latae and the rectus femoris to open the capsule without detachment of muscles. Especially, the external rotators and posterior capsule remain intact and reduce the risk of posterior dislocation. Accuracy of acetabular component positioning has an impact on postoperative dislocation rates, polyethylene wear, and impingement. When the operation is done in a supine position, fluoroscopy is available to check the acetabular component inclination and anteversion during THA as well as leg length and offset. The current chapter reports on the surgical approach, surgical technique, and results of anterior THA.

show abstract

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Cited by 132 publications

References 34 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

Comparison of clinical characteristics and 10-year survival rates of revision hip arthroplasties among revision time groups

Anterior Primary Total Hip Arthroplasty

Contact Info

Product

Resources

About