Little Clinical Advantage of Modified Watson-Jones Approach Over Modified Mini-Incision Direct Lateral Approach in Primary Total Hip Arthroplasty

Inaba, Yutaka; Kobayashi, Naomi; Yukizawa, Yohei; Ishida, Takashi; Iwamoto, Naoyuki; Saito, T.

doi:10.1016/j.arth.2011.04.002

Cited by 34 publications

(38 citation statements)

References 15 publications

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“…But already 12 weeks after surgery both groups were on the same level. This corresponds to the results of Inaba et al ., who also evaluated a better, but non-significant, recovery during the first six weeks after surgery 26 . However, this only applied to the first six weeks, not to the longer follow-up.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

et al. 2013

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There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

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Section: Discussionmentioning

confidence: 99%

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

et al. 2013

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“…A number of recent studies have compared the newer approaches with traditional lateral and posterior approaches [1,12,15,18,34,49] but there is lack of consensus on whether there is any demonstrable difference in reducing muscle damage, improving postoperative gait, or facilitating earlier rehabilitation [21,29,38,41,42,46].…”

Section: Introductionmentioning

confidence: 99%

Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk

Sheth

Cafri

Inacio

et al. 2015

Clinical Orthopaedics &Amp; Related Research

190

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Background Lack of consensus continues regarding the benefit of anteriorly based surgical approaches for primary total hip arthroplasty (THA). The purpose of this study was to evaluate the risk of aseptic revision, septic revision, and dislocations for various approaches used in primary THAs from a community-based healthcare organization. Questions/purposes (1) What is the incidence of aseptic revision, septic revision, and dislocation for primary THA in a large community-based healthcare organization? (2) Does the risk of aseptic revision, septic revision, and dislocation vary by THA surgical approach? Methods The Kaiser Permanente Total Joint Replacement Registry was used to identify primary THAs performed between April 1, 2001 and December 31, 2011. Endpoints were septic revisions, aseptic revisions, and dislocations. The exposure of interest was surgical approach (posterior, anterolateral, direct lateral, direct anterior). Patient, implant, surgeon, and hospital factors were evaluated as possible confounders. Survival analysis was performed with marginal multivariate Cox models. Hazard ratios (HRs) and 95% confidence intervals (CIs) are reported. A total of 42,438 primary THAs were available for analysis of revision outcomes and 22,237 for dislocation. Median followup was 3 years (interquartile range, 1-5 years). The registry's voluntary participation is 95%. The most commonly used approach was posterior (75%, N = 31,747) followed by anterolateral (10%, N = 4226), direct anterior (4%, N = 1851), and direct lateral (2%, N = 667). Results During the study period 785 hips (2%) were revised for aseptic reasons, 213 (0.5%) for septic reasons, and 276 (1%) experienced a dislocation. The revision rate per 100 years of observation was 0.54 for aseptic revisions, 0.15 for septic revisions, and 0.58 for dislocations. There were no differences in adjusted risk of revision (either septic or aseptic) across the different THA approaches. However, the anterolateral approach (adjusted HR, 0.29; 95% CI, 0.13-0.63, p = 0.002) and direct anterior approach (adjusted HR, 0.44; 95% CI, 0.22-0.87, p = 0.017) had a lower risk of dislocation relative to the posterior approach. There were no differences in any of the outcomes when comparing the direct anterior approach with the anterolateral approach. Conclusions Anterior and anterolateral surgical approaches had the advantage of a lower risk of dislocation without increasing the risk of early revision. Level of Evidence Level III, therapeutic study.

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“…All surgeries were performed patient in the lateral position on the operating table, using a modified mini-incision direct lateral approach[19]. A CT-based navigation system was used for all cases in the current study(Stealth Station TREON Plus, Medtronic Inc., Louisville, KY), along with metal-backed acetabular cups and cementless femoral stems.…”

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confidence: 99%

Postural and Chronological Change in Pelvic Tilt Five Years After Total Hip Arthroplasty in Patients With Developmental Dysplasia of the Hip: A Three-Dimensional Analysis

Suzuki

Inaba

Kobayashi

et al. 2016

The Journal of Arthroplasty

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Little Clinical Advantage of Modified Watson-Jones Approach Over Modified Mini-Incision Direct Lateral Approach in Primary Total Hip Arthroplasty

Cited by 34 publications

References 15 publications

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk

Postural and Chronological Change in Pelvic Tilt Five Years After Total Hip Arthroplasty in Patients With Developmental Dysplasia of the Hip: A Three-Dimensional Analysis

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