Minimally invasive total hip arthroplasty

Lee, Mel Shiuann-Sheng

doi:10.1016/j.fjmd.2011.03.001

Cited by 4 publications

(4 citation statements)

References 44 publications

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“…All of the patients underwent standardized THA via direct lateral approach [ 25 , 26 ] using a Zimmer Trilogy Cup, VerSys Fiber Metal Taper Stem, and highly cross-linked polyethylene, coupled with a 32 mm metal head. An experienced surgeon performed all of the procedures.…”

Section: Methodsmentioning

confidence: 99%

Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial

Huang

Shih

Chang

et al. 2017

BMC Musculoskelet Disord

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BackgroundAlthough the loss of bone mineral density (BMD) after total hip arthroplasty (THA) is a known problem, it remains unresolved. This study prospectively examined the effect of zoledronic acid (ZA) on bone turnover and BMD after cementless THA.MethodsBetween January 2010 and August 2011, 60 patients who underwent cementless THA were randomly assigned to receive either ZA infusion or placebo (0.9% normal saline only) postoperatively. ZA was administered at 2 day and 1 year postoperatively. Periprosthetic BMD in seven Gruen zones was assessed preoperatively and at given time points for 2 years. Serum markers of bone turnover, functional scales, and adverse events were recorded.ResultsEach group contained 27 patients for the final analysis. The loss of BMD across all Gruen zones (significantly in zones 1 and 7) up to 2 years postoperatively was noted in the placebo group. BMD was significantly higher in the ZA group than in the placebo group in Gruen zones 1, 2, 6, and 7 at 1 year and in Gruen zones 1, 6, and 7 at 2 years (p < 0.05). Compared with baseline measures of BMD, the ZA group had increased BMD in zones 1, 2, 4, 5, 6, and 7 at 1 year and in zones 1, 4, 6, and 7 at 2 years (p < 0.05). Serum bone-specific alkaline phosphatase and N-telopeptide of procollagen I levels were significantly increased at 6 weeks in the placebo group and decreased after 3 months in the ZA group. A transient decrease in osteocalcin level was found at 6 months in the ZA group. Functional scales and adverse events were not different between the two groups.ConclusionsThe loss of periprosthetic BMD, especially in the proximal femur (zones 1 and 7), after cementless THA could be effectively reverted using ZA. In addition, bone turnover markers were suppressed until 2 years postoperatively following ZA administration.Trial registrationChang Gung Memorial Hospital Protocol Record 98-1150A3, Prevention of Periprosthetic Bone Loss After Total Hip Replacement by Annual Bisphosphonate Therapy, has been reviewed and will be made public on ClinicalTrials.gov. Trial registration number: NCT02838121. Registered on 19 July, 2016.

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Section: Methodsmentioning

confidence: 99%

Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial

Huang

Shih

Chang

et al. 2017

BMC Musculoskelet Disord

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“…19 As a contrast, Lee et al reported 2 to 3.1% intraoperative periprosthestic fracture rate for the twoincision THA and the complication rates could be diminished with increasing experience and use of intraoperative fluoroscopic guidance. 7,20,21 There were 10 cases (6.3%) with intraoperative femoral fractures, 34 cases (21.4%) with temporary LFCN palsy, and 3 revision cases (one for septic loosening in the dysplasia group and two for the stem revision in the ONFH group for periprosthetic fracture). With a mean follow-up of 9 to 10 years, the overall implants survival rate is 98% in the ONFH group and 98.3% in the dysplasia group.…”

Section: Discussionmentioning

confidence: 99%

A 6 to 10 Years Follow-Up Study Comparing Two-incision Total Hip Arthroplasties in Patients with Osteonecrosis of the Femoral Head or Hip Dysplasia

Chen

Kou

et al. 2017

J Hip Surg

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Muscle sparing approaches for total hip arthroplasties (THAs) have been advocated in the past two decades. The twoincision approach technique is one of the muscle sparing approaches. The technique has the potential benefits of avoiding muscle and tendon damage, less intraoperative blood loss, rapid patient recovery, and shortened hospitalization but might increase complications such as fractures, nerve injury, and implants malposition, so it required a steep learning curve.1-6 The ideal cup position, stem alignment, and proper leg length and offset are the keys to a successful THA. Our previous study has demonstrated that using of intraoperative fluoroscopy or imageless navigation system can increase the accuracy of cup and stem alignment for the two-incision THA. AbstractTwo-incision total hip arthroplasty (THA) has a steep learning curve and might increase the risks of implant malposition and perioperative complications in difficult cases. Whether dysplasic hip or osteonecrosis of the femoral head (ONFH) would have different results by the two-incision technique remains unreported. From 2003 to 2010, 159 hips in 151 patients (68 female and 83 male) treated with the two-incision THA were included. Cases were divided into two groups with ONFH in 99 hips and dysplasia in 60 hips. The inclusion criteria for hip dysplasia were a Sharp's angle more than 43°and coverage of the femoral head less than 75%. Clinical data and radiological measurement were retrospectively analyzed. The ONFH patients had younger age (48.5 AE 12.8 years) with male predominance (74%) while the dysplasic patients had older age (62 AE 12 years) with female predominance (76%). There were no differences in preoperative functional score, operation time, blood loss, wound size, and length of hospital stay between groups. The ONFH group had bigger cup size (p ¼ 0.028) but similar stem size (p ¼ 0.072) as compared with the dysplasia group. The cup inclination angle was 43.7°AE 4.8°and 42.8°AE 5°(p ¼ 0.25) and the cup anteversion angle was 17.6°AE 7.6°and 14.2°AE 8.2°(p ¼ 0.009), in the ONFH and the dysplasia group, respectively. At the final follow-up, there were three revisions cases (one septic loosening in the dysplasia group and two periprosthetic fractures in the ONFH group). No dislocation was noted in the study cohort. We had overall 99.4% cup and 98.1% stem survival rate with the two-incision THA. The only differences were the bigger cup size and the more anteverted cup position in the ONFH hips as compared with the dysplasic hips. The two-incision THA seemed to be successful for patients with ONFH or dysplasic hips.

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“…Minimally invasive surgery (MIS) approaches to THA have been introduced in response to increased patient demands and expectations [2–8]. Early reports suggest that MIS lessens blood loss, pain, and hospital stay and results in early functional recovery compared with conventional approaches [5–7]. However, the merits of different MIS approaches are still controversial, and functional outcomes among the different surgical approaches vary [4, 8].…”

Section: Introductionmentioning

confidence: 99%

A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

Lin

Huang

Lin

et al. 2017

BioMed Research International

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Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p < 0.05 for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

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Minimally invasive total hip arthroplasty

Cited by 4 publications

References 44 publications

Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial

Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial

A 6 to 10 Years Follow-Up Study Comparing Two-incision Total Hip Arthroplasties in Patients with Osteonecrosis of the Femoral Head or Hip Dysplasia

A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

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