Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial. The protocol v1

Kruse, Christine; Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

doi:10.17504/protocols.io.jpbcmin

Cited by 3 publications

(1 citation statement)

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“…11 Kruse et al compared radiographic outcomes of posterior and lateral approaches in 80 patients and reported that the femoral offset and abductor moment arm were significantly increased when using a posterior compared with a lateral approach. 12 Moon et al compared two techniques of posterior soft tissue repair in 167 hips (150 patients) at 28 months follow-up and reported better outcomes and fewer dislocations with a transosseous repair compared with gluteus medius/short rotators tendon-to-tendon repair 13 ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Surgical Approaches in Primary Total Hip Arthroplasty: Systematic Review of Randomized Controlled Trials

Matar¹,

Bloch²,

Platt

et al. 2022

The Journal of Hip Surgery

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The aim of this study was to provide an overview of randomized controlled trials (RCTs) of surgical approaches in primary total hip arthroplasty (THA), summarizing the available high-quality evidence. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we performed the electronic searches in January 2021. We searched the Cochrane Central Register of Controlled Trials (2021, Issue 1), Ovid MEDLINE (including e-pub ahead of print, in-process, and other non-indexed citations, Ovid MEDLINE Daily, Ovid MEDLINE and Versions) (1946–January 20, 2021), and Embase (1980–January 20, 2021). We limited our search to English language literature. We excluded nonrandomized trials, trials on neck of femur fractures or revision surgery, systematic reviews, and meta-analyses. Trials that met our inclusion criteria were assessed using a binary outcome measure of whether they reported statistically significant findings. These were then classified according to the intervention groups. A total of 72 RCTs met the inclusion criteria. The total number of patients in those trials was 6,728. Only five RCTs (5.9%) reported significant differences between the intervention and the control groups. The largest subgroup of trials was minimally invasive versus standard techniques (18 RCTs) with no significant differences. Standard (lateral, posterior) approaches were compared in 23 RCTs with only 1 RCT reporting significant differences. Thirteen RCTs evaluated mini-incisions, with only 1 RCT reporting significant differences, and the remaining 18 RCTs evaluated variations of surgical approaches and interventions, with 3 RCTs reporting significant differences. The evidence reviewed indicates that for the vast majority of patients, a standard THA approach familiar to the surgeon leads to comparable outcomes. Level of evidence is II.

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Section: Resultsmentioning

confidence: 99%

Surgical Approaches in Primary Total Hip Arthroplasty: Systematic Review of Randomized Controlled Trials

Matar¹,

Bloch²,

Platt

et al. 2022

The Journal of Hip Surgery

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Excellent Clinical and Radiographic Outcomes with Direct Superior Total Hip Arthroplasty with a Minimum of Two-Year Follow Up

et al. 2021

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This study aims to establish the midterm safety and performance for the direct superior approach to minimally invasive surgery total hip arthroplasty (MIS-THA). We used a unicentric, single-surgeon, retrospective, consecutive case series analysis of the first 40 patients who received primary unilateral direct superior MIS-THA. Special attention was given to functional recovery by measuring Harris Hip Score (HHS) and timed-up-and-go (TUG) with a mean follow up of 2.2 ± 0.4 years. A radiologic evaluation was performed. HHS and TUG improved significantly at three months and one year (p < 0.001). All components were placed within the Lewinnek safe zone with no change position or signs of loosening at two years. With a minimum of two years of follow up, the direct superior approach appears to be safe without any obvious or consistent postoperative complications—clinically or radiographically—with excellent functional recovery. Additionally, our subgroup analysis supported no late learning curve effect.

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Case-Controlled Analysis of the Direct Superior and Mini-Posterior Approach for Total Hip Arthroplasty at a Minimum of Two Years of Follow Up

et al. 2021

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Introduction: The direct superior approach to total hip arthroplasty (THA) is a recently developed technique aimed at sparing the iliotibial band, obturator externus tendon, and quadratus femoris muscle while working within the familiar anatomical landscape of the posterior approach. While the direct superior approach has been used for more than a decade, there is a lack of midterm outcomes and safety data. This study elaborates on promising short-term results and aims to investigate the midterm outcomes of the direct superior approach. Materials and Methods: We present a unicentric, retrospective case-controlled analysis of a minimum two-year follow up of the direct superior approach in comparison to those of the more conventional and established mini-posterior approach. Results: The results indicate that patient recovery, as measured by Harris Hip Score and timed-up-and-go at three months and two years, are virtually identical. There was no difference in gait aid utilization or frequency of narcotic use. However, there was a statistically significant reduction in length of stay by over one day associated with the direct superior approach (p=0.003). There was no compromise in acetabular component position or observed lucencies over time. Conclusion: Overall, the direct superior approach appears to be safe and warrants longer-term study to evaluate its effect on hospital-related cost, same-day discharge, and hip stability.

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Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial. The protocol v1

Cited by 3 publications

References 0 publications

Surgical Approaches in Primary Total Hip Arthroplasty: Systematic Review of Randomized Controlled Trials

Surgical Approaches in Primary Total Hip Arthroplasty: Systematic Review of Randomized Controlled Trials

Excellent Clinical and Radiographic Outcomes with Direct Superior Total Hip Arthroplasty with a Minimum of Two-Year Follow Up

Case-Controlled Analysis of the Direct Superior and Mini-Posterior Approach for Total Hip Arthroplasty at a Minimum of Two Years of Follow Up

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