Minimally Invasive Total Hip Arthroplasty: A Comparison of Restoring Hip Biomechanics With and Without a Traction Table

Lenze, Florian; Hinterwimmer, Florian; FLECKENSTEIN, LISA; Lazic, Igor; Dammerer, Dietmar; Eisenhart-Rothe, Rüdiger von; Harrasser, Norbert; Pohlig, Florian

doi:10.21873/invivo.12720

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Due to the traction table, the authors were unable to take radiographs of both hips to check for LLD. Other teams have used a standard instead of a traction table to intraoperatively control lengths, with some reporting leg length reconstruction as more accurate in the traction table group (0.56 versus 1.78 mm)[ 25 ]. However, others have reported that both techniques provided equal results [ 5 ], and some have reported that leg length restoration was significantly more accurate without a traction table (2.4 versus 3.7 mm)[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Managing early complications in total hip arthroplasty: the safety of immediate revision

Descamps,

Teissier,

Graff

et al. 2023

J Orthop Traumatol

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Purpose Immediate revision refers to a reoperation that involves resetting, draping, and exchanging the implant, after wound closure in total hip arthroplasty. The purpose of this study is to investigate the impact of immediate revision after total hip arthroplasty on subsequent infection and complication rates. Methods A total of 14,076 primary total hip arthroplasties performed between 2010 and 2020 were identified in our institutional database, of which 42 underwent immediate revision. Infection rates were determined 2 years after the index arthroplasty. The cause and type of revision, duration of primary and revision surgeries, National Nosocomial Infections Surveillance score, implant type, changes in implants, complications, and preoperative and intraoperative antibiotic prophylaxis were all determined. Results No infections were observed within 2 years after the index arthroplasty. Leg length discrepancy (88%, n = 37) and dislocation (7.1%, n = 3) were the main causes of immediate revision. In most cases of discrepancy, the limb was clinically and radiologically longer before the immediate revision. The mean operative time was 48 ± 14 min for the primary procedure and 23.6 ± 9 min for the revision. The time between the first incision and last skin closure ranged from 1 to 3 h. None of the patients were extubated between the two procedures. Two patients had a National Nosocomial Infections Surveillance score of 2, 13 had a score of 1, and 27 had a score of 0. Conclusion Immediate revision is safe for correcting clinical and radiological abnormalities, and may not be associated with increased complication or infection rates. Study design Retrospective cohort study; level of evidence, 3.

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Section: Discussionmentioning

confidence: 99%

Managing early complications in total hip arthroplasty: the safety of immediate revision

Descamps,

Teissier,

Graff

et al. 2023

J Orthop Traumatol

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“…Therefore, different surgical approaches may affect the resistance to traction by the joint capsule. In addition, when the traction force exceeds 250 N, the vacuum negative pressure in the joint capsule will provide more than half of the antagonistic force [12, 16, 21]. The traction force in hip arthroscopic surgery obviously exceeds this threshold, so a large part of the force is to resist this vacuum negative pressure.…”

Section: Discussionmentioning

confidence: 99%

The traction force of the pulled limb in hip arthroscopic surgery is determined by stiffness coefficient which is significantly related to muscle volume

Yin

Xue

Zhang

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stifness coeicient (SC). To analyse the diference of traction force at diferent physical states of hip joint capsule. Methods Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by 3D Slicer. We recorded and tested diferences in traction force of ive joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was veriied by Spearman test. Poisson regression was used to explain confounding variables. ResultsThe average force at State 1 was 531.8 N. There were signiicant diferences in traction force between these ive states (p < 0.001). There was a signiicant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the afected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.). ConclusionThe physical states of the hip joint capsule afected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA afected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient. Levels of evidence IV.

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Enhancing recovery: surgical techniques and rehabilitation strategies after direct anterior hip arthroplasty

Di Martino,

Keating,

Butsick

et al. 2024

J Orthop Traumatol

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Total hip arthroplasty (THA) is a common surgical procedure for hip joint pathologies, with the direct anterior approach (DAA) gaining popularity due to potential benefits in postoperative recovery. This review aims to provide a comprehensive analysis of rehabilitation strategies following DAA THA, focusing on surgical techniques, postoperative care, and outcomes. The evolution of the DAA to THA is discussed, highlighting historical advancements and comparisons with other surgical approaches. Surgical techniques and considerations specific to the DAA are detailed, including outcomes and complications compared to alternative approaches. The role of the surgical technique in influencing postoperative rehabilitation is explored, emphasizing the importance of optimizing surgical procedures for enhanced recovery. Postoperative care and rehabilitation models following DAA THA are examined, with a focus on the impacts of different rehabilitation protocols on patient outcomes. The review underscores the significance of tailored rehabilitation programs in promoting optimal recovery and patient satisfaction. Current evidence from recent studies, meta-analyses, and clinical trials is critically analyzed to provide insights into the effectiveness of postoperative rehabilitation strategies. The review identifies gaps in the existing literature and proposes recommendations for future research to improve rehabilitation protocols and enhance outcomes. In conclusion, this review highlights the importance of postoperative rehabilitation in the context of DAA THA. By synthesizing historical perspectives, current evidence, and future directions, the review offers a comprehensive understanding of rehabilitation strategies following DAA THA. The findings underscore the need for personalized rehabilitation programs and ongoing research to optimize postoperative recovery and improve outcomes in the field of THA.

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Minimally Invasive Total Hip Arthroplasty: A Comparison of Restoring Hip Biomechanics With and Without a Traction Table

Cited by 4 publications

References 18 publications

Managing early complications in total hip arthroplasty: the safety of immediate revision

Managing early complications in total hip arthroplasty: the safety of immediate revision

The traction force of the pulled limb in hip arthroscopic surgery is determined by stiffness coefficient which is significantly related to muscle volume

Enhancing recovery: surgical techniques and rehabilitation strategies after direct anterior hip arthroplasty

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