Spontaneous healing of lateral femoral cutaneous nerve injury and improved quality of life after total hip arthroplasty via a direct anterior approach

Ozaki, Yu; Homma, Yasuhiro; Baba, Tomonori; Sano, Kei; Desroches, Asuka

doi:10.1177/2309499016684750

Cited by 27 publications

(20 citation statements)

References 21 publications

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“…Several reports have stated that LFCN injury does not affect hip joint function after THA (6,20,21). Indeed, the presence of LFCN injury did not affect improvement in joint function in our previous study (22). In the same group of patients, however, we demonstrated that LFCN injury reduced the QOL after surgery (10,22).…”

Section: Discussionsupporting

confidence: 41%

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Medial Versus Conventional Approach for Prevention of Lateral Cutaneous Nerve Injury in Total hip Arthroplasty with Direct Anterior Approach: A Study for Dual-center, Single-blind, Randomized Controlled Trial

Tanabe¹,

Baba²,

Ozaki³

et al. 2020

Preprint

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Background; Lateral cutaneous nerve (LFCN) injury is one of the complication specific to total hip arthroplasty via the direct anterior approach. Recent anatomical studies have revealed that the LFCN not only courses between the sartorius and tensor fasciae latae muscles, but it also branches radially while distributing in the transverse direction from the sartorius muscle to the tensor fasciae latae muscle. The latter is called the fan type, in which injury of the LFCN is almost unavoidable using the conventional site for incision of the fascia. In order to reduce LFCN injury in the fan type, we devised a new approach of incising the fascia at a side 2 cm medial from the conventional site of incision. The purpose of this study is to examine how the site of incision of the fascia influences LFCN injury.Methods; This is a prospective, randomized, controlled study. All patients are divided into the fan type and non-fan type using ultrasonography before surgery. Patients with the fan type LFCN will be performed by the conventional approach and the medial approach in the order specified in the allocation table created in advance by our clinical trial center. The conventional approach involves incision of the skin, followed by incision of the fascia just below the site of skin incision. The medial approach proceeds medially from the site of skin incision, and involves incision of the fascia at a site 2 cm medial from the conventional site of incision. The primary endpoint is the presence of LFCN injury. The secondary endpoints will be assessed based on PROs at 3 months after surgery in an outpatient setting using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and the Forgotten-Joint Score-12 (FJS-12).Discussion; We hypothesize that the fan type LFCN can be protected from injury by incising the fascia at a more medial site than conventional site. If the usefulness of this surgical procedure is confirmed, the disadvantages of the DAA will be eliminated, potentially being highly beneficial to patients.Trial registration; UMIN Clinical Trials Registry, UMIN000035944.Registered on 20 Feburary 2019.

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Section: Discussionsupporting

confidence: 41%

“…Indeed, the presence of LFCN injury did not affect improvement in joint function in our previous study (22). In the same group of patients, however, we demonstrated that LFCN injury reduced the QOL after surgery (10,22). Therefore, we believe that reducing LFCN injury is essential for improving the outcome of THA using the DAA.…”

Section: Discussionmentioning

confidence: 56%

Medial Versus Conventional Approach for Prevention of Lateral Cutaneous Nerve Injury in Total hip Arthroplasty with Direct Anterior Approach: A Study for Dual-center, Single-blind, Randomized Controlled Trial

Tanabe¹,

Baba²,

Ozaki³

et al. 2020

Preprint

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“…21 , 24 Critics claim that safety and efficacy of MIS have yet to be determined. 22-23 Frequently in combination with MIS THA, different types of short femoral stems, commercially available, preserve more femoral bone and make a possible revision surgery, in the future, less complicated. These advantages may simplify even more a simultaneous bilateral THA.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, several studies have also reported that the MIS-THA significantly reduced postoperative pain and led to faster postoperative rehabilitation when compared with the respective traditional approaches. 22-29 In addition, a simultaneous bilateral one stage MIS-THA (1-MIS-BTHA) with either anterolateral or direct anterior approach could be performed in supine position which may facilitate the surgeon to operate on the contralateral side without the necessity of changing the patient’s position (in contrast to the posterior approach). Therefore, MIS-THA could be the most suitable operative technique for the better outcome in the patients undergoing 1- BTHA.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous bilateral minimally invasive total hip arthroplasty: A comprehensive review of the literature

Malahias¹,

Chulsomlee

Thorey³

2018

Orthop Rev (Pavia)

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Several studies have reported that minimally- invasive total hip arthroplasty (MISTHA) may significantly reduce postoperative pain and results in faster postoperative rehabilitation when compared with the traditional lateral or posterior approach. Regarding bilateral hip osteoarthritis, there is still no consensus whether simultaneous bilateral MIS-THA can be established as the treatment of choice. Therefore, we searched the international databases of Pubmed, Medline, and Cochrane Database of Systematic Reviews using the key words minimally invasive bilateral total hip arthroplasty. From the initial 23 articles we found five clinical studies which met our inclusion criteria. From the perspective of possible intra- and postoperative complications, one-stage bilateral MIS THA was equally safe or safer than two-stage interventions. In addition, from a clinical outcome perspective, the one-stage procedure can be considered to be preferable. Higher blood transfusion requirements, which were expected following the standard bilateral simultaneous THA, seemed to be minimized with the simultaneous bilateral MIS THA. The supine position of the patient minimized the mean operation time. Approaches using the lateral decubitus position of the patient should be avoided in simultaneous bilateral THA due to the increased operation time. There is a lack of randomized, controlled clinical trials, comparing simultaneous bilateral MIS THA with staged bilateral MIS THA. Although simultaneous bilateral MIS THA seems to be efficacious, cost-effective and safe, more clinical trials are required to establish its superiority over the sequential MIS THA.

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“…Also, compared with the greater trauma of the conventional approach, minimally invasive surgery cannot be de ned by short incision solely. For instance, direct anterior access may injury the lateral femoral cutaneous nerve [24]; lateral approach may injure the superior gluteal nerve and cut off the insertion of gluteus minimus [25]; the posterior lateral approach needed to cut the piriformis muscle and then expose joint capsule [26]. In terms of minimally invasive surgery, the SuperPATH technology was a true minimally invasive technique.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of SuperPATH approach in hip arthroplasty

Zhou

Chen

et al. 2020

Preprint

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Background: To compare the clinical and radiographic results of supercapsular percutaneously assisted total hip (SuperPATH) approach and conventional approach by systematic review and meta-analysis. Methods: Based on a pre-published protocol (PROSPERO CRD42020177717), we systematically retrieved databases from Pubmed, Embase, Cochrane and Web of Knowledge for relevant literatures from the earliest available date to May 30, 2020. No language restriction was applied. RevMan 5.3 software was used to perform the meta-analysis. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Two reviewers were independently extracted data from all eligible studies, including types of studies, participants, interventions, and outcomes. Randomized or fixed-effect models were used to calculate the weighted mean difference (WMD), odds ratio (OR) for continuous and dichotomous variables, respectively.Results: 6 articles were included in the study and 526 patients were selected, which was including 233 cases in the SuperPATH groups, 279 cases in the conventional groups and 4 cases performed two surgeries in succession. The SuperPATH group demonstrated shorter incision length (WMD = - 7.87, 95 % CI - 10.05 to - 5.69, P < 0.00001), decreased blood transfusion rate (OR = 0.48, 95 % CI 0.25 to 0.89, P = 0.02), decreased visual analogue scale (VAS) (WMD = -0.40, 95 % CI - 0.72 to - 0.08, P = 0.03) and higher Harris hip score (HHS) (WMD = 1.98, 95 % CI 0.18 to 3.77, P = 0.0002) than those in the conventional group. However, there was no difference in VAS and HHS between the two groups half a year later. There was no significant difference in the acetabular abduction angle (WMD = - 1.32, P = 0.32) in either group. Conclusions: SuperPATH minimally invasive approach with its reduced tissue damage, quick postoperative recovery and early rehabilitation demonstrates the short-term advantages of hip arthroplasty. However, the evidence for SuperPATH technique was limited in the number of studies and short duration of follow-up, so long-term results still need further analysis.

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Spontaneous healing of lateral femoral cutaneous nerve injury and improved quality of life after total hip arthroplasty via a direct anterior approach

Cited by 27 publications

References 21 publications

Medial Versus Conventional Approach for Prevention of Lateral Cutaneous Nerve Injury in Total hip Arthroplasty with Direct Anterior Approach: A Study for Dual-center, Single-blind, Randomized Controlled Trial

Medial Versus Conventional Approach for Prevention of Lateral Cutaneous Nerve Injury in Total hip Arthroplasty with Direct Anterior Approach: A Study for Dual-center, Single-blind, Randomized Controlled Trial

Simultaneous bilateral minimally invasive total hip arthroplasty: A comprehensive review of the literature

A systematic review and meta-analysis of SuperPATH approach in hip arthroplasty

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