No Difference in Dislocation Seen in Anterior Vs Posterior Approach Total Hip Arthroplasty

Maratt, Joseph D.; Gagnier, Joel; Butler, Paul D.; Hallstrom, Brian R.; Urquhart, Andrew G.; Roberts, Karl C.

doi:10.1016/j.arth.2016.02.071

Cited by 125 publications

(95 citation statements)

References 19 publications

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“…9 While these findings have been supported elsewhere in the literature, 14,15 younger patients may have shorter LOS after THA in general. 16,17 There has been no evidence to suggest long-term clinical benefits of anterior compared to posterior-THA regardless of age, 9,18,19,20,21 which is also consistent with our study, as there was no difference between groups with respect to postoperative complications.…”

Section: Discussionsupporting

confidence: 86%

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

Luthringer¹,

Novikov²,

Gabor³

et al.

EPiC Series in Health Sciences

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PURPOSE: Indications for total hip arthroplasty (THA) are expanding to include increasingly younger patients, yet limited outcomes research has focused on this population. This study compares outcomes between the anterior and posterior approach, as well as between conventional and technology-assisted THA in patients under 35-years of age.METHODS: Retrospective analysis of 139 primary THAs in 125 patients younger than 35-years old was conducted. Patients were divided into two cohorts: (1) anterior-THA and (2) posterior-THA. A posterior-THA sub-group analysis was performed to compare: (1) technology-assisted THA (tech-THA) versus (2) conventional-THA (con-THA). Demographics, perioperative data, radiographic and clinical outcomes were analyzed using Chi squared and unpaired student t-tests for categorical and continuous variables, respectively.RESULTS: Of the 139 cases performed, 40 were anterior-THA and 99 were posterior-THA. The anterior-THA cohort had shorter mean surgical time (95.0±25.7 vs. 118.3±43.3 minutes; p<0.01), shorter hospital admissions (1.9±1.4 vs. 2.7±1.2 days; p<0.01), and lower estimated blood loss (343.4±164.1 vs. 438.0±272.8 mL; p<0.01) compared to the posterior-THA cohort. There were no significant differences in component positioning, limb length discrepancy, clinical outcomes or postoperative complications between cohorts. In the sub-group analysis, cup placement within Lewinnek’s Safe Zone was achieved in 78% of tech-THA versus 49% of con-THA (p<0.01). Need for revision THA was significantly higher among the con-THA group (9.4% vs. 0%; p<0.01).CONCLUSION: There is no significant difference in outcomes between anterior- and posterior-THA among patients under 35-years of age, however, the anterior approach may promote earlier hospital discharge. Technological-assistance can improve component positioning and may reduce the rate of revision for posterior-THA in patients under 35-years old.

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Section: Discussionsupporting

confidence: 86%

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

Luthringer¹,

Novikov²,

Gabor³

et al.

EPiC Series in Health Sciences

View full text Add to dashboard Cite

show abstract

“…The prevalence rate of THA dislocations is affected by multiple factors that can be grouped in patient-specific [3,4], surgeon-specific [5] and factors related to the implant design [6,7], implant alignment [8], and surgery technique [9]. Acetabular component alignment is considered to play an important role in THA dislocations [10].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Body Position on Pelvic Tilt Angles Measured with a Smartphone-Based Navigated Ultrasound System in Symptom-Free Young Adults

Marques

Martín

Fiedler

et al. 2018

JFMK

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Abstract:The study aimed to investigate whether pelvic tilt (PT) angles differ between the supine and upright position in symptom-free young adults. Additionally, the concurrent validity of the measurement system was tested on a pelvis phantom against a digital inclinometer. A new smartphone-based navigated ultrasound system was used to perform the measurements. The sample consisted of 12 symptom-free young adults. A multivariate regression model was used to analyze the data. The subjects' pelvis in supine position was significantly more tilted anteriorly (mean PT = −7.3 • , 95% C.I.: −10.6 to −3.9) than in upright position (mean PT = 0.8 • , 95% C.I.: −2.5 to 4.1) (mean. diff. 8.1 • ; p < 0.001). Rater and trial order had no significant effects on the measured PT angles (p = 0.5). The accuracy of the system when measuring PT angles on the pelvis phantom was 0.3 • (0.1 • to 0.7 • ) and 0.2 • (−0.09 • to 0.6 • ) for the supine and upright positions respectively. Pelvic tilt angles differed significantly between the supine and the upright position in symptom-free young adults. Concurrent validity showed no differences for measurements in the upright position and small (under 0.4 • ) significant differences for measurements in the supine position.

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“…Sheth et al ., in a large registry study on 42,438 primary THAs, also reported significantly lower dislocation rates with both DAA and anterolateral approach versus PA 34. However, other studies have reported equivalent rates of dislocation for all approaches, and hence, the data are not completely clear 32515253…”

Section: Discussionmentioning

confidence: 99%

Surgical Approaches for Total Hip Arthroplasty

Moretti

Post

2017

IJOO

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Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches. A review of outcomes and complications for each approach are also provided. Each approach has its own unique advantages and disadvantages, but all can be safely and successful utilized for THA. Strong, convincing, high-quality studies comparing the different approaches are lacking at this time. Surgeons are therefore recommended to choose whichever approach they are most comfortable and experienced using. Though not described here, THA can also be done using the anterolateral approach (also known as the Watson Jones approach) as well as the two-incision approach. In addition, recently, some surgeons are utilizing the so-called direct superior approach for THA. While these approaches are far less commonly utilized, they are recognized as viable alternatives to traditional approaches.

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No Difference in Dislocation Seen in Anterior Vs Posterior Approach Total Hip Arthroplasty

Cited by 125 publications

References 19 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

The Effects of Body Position on Pelvic Tilt Angles Measured with a Smartphone-Based Navigated Ultrasound System in Symptom-Free Young Adults

Surgical Approaches for Total Hip Arthroplasty

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