Supine versus lateral position for accurate positioning of acetabular cup in total hip arthroplasty using the modified Watson-Jones approach: A randomized single-blind controlled trial

Takada, Ryohei; Jinno, Tetsuya; Miyatake, Kazumasa; Hirao, Masanobu; Yagishita, Kazuyoshi; Yoshii, Toshitaka; Okawa, Atsushi

doi:10.1016/j.otsr.2019.05.004

Cited by 29 publications

(15 citation statements)

References 32 publications

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“…Third, the present study was a multicenter prospective study. Unlike previous reports that were performed at single institutions [4][5][6][7] , the present study reproduced a scenario that was closer to a normal clinical setting.…”

Section: Discussionsupporting

confidence: 43%

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The Accuracy And Influencing Factors of An Accelerometer-Based Portable Navigation System For Total Hip Arthroplasty In The Supine Position : A Prospective Multicenter Study Using 3D CT Measurement

Minoda

Ito²,

Iwakiri

et al. 2021

Preprint

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This multicenter prospective study aimed to evaluate the accuracy of a newly introduced accelerometer-based portable navigation system for total hip arthroplasty (THA) in the supine position. Three hundred twenty-four THAs using supine position in 9 hospitals were prospectively enrolled in the study. An accelerometer-based portable navigation system was used for cup fixation and the intraoperative navigation data (cup alignment, pelvic tilt, and pelvic rotation) were recorded. Postoperative cup alignment was measured on 3D-CT images. The accuracy (absolute difference in cup alignment between the intraoperative navigation record and postoperative 3D-CT measurements) was 3 ± 3° (mean ± standard deviation) for cup inclination and 3 ± 3° for cup anteversion. The pelvis tilted anteriorly in 148 hips (46%) and posteriorly in 162 hips (50%), and did not tilt in 14 hips (4%). The pelvis rotated toward the operating side in 179 hips (55%), toward the contralateral side in 112 hips (35%), and did not rotate in 33 hips (10%). Multiple regression analysis showed that the patients’ characteristics, pelvic tilt, and pelvic rotation did not affect the accuracy of the navigation system. The accuracy was 3 ± 3° and not affected by patient characteristics, surgical factors, or substantial pelvic movement during cup fixation.

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Section: Discussionsupporting

confidence: 43%

“…Accelerometer-based portable navigation systems, which provides lower cost and portability without a large computer and sensor, were introduced in 2016, with subsequent studies showing high levels of accuracy [4][5][6][7] . However, these reports were all single-institution studies and the procedures were performed by only a few surgeons.…”

Section: Introductionmentioning

confidence: 99%

The Accuracy And Influencing Factors of An Accelerometer-Based Portable Navigation System For Total Hip Arthroplasty In The Supine Position : A Prospective Multicenter Study Using 3D CT Measurement

Minoda

Ito²,

Iwakiri

et al. 2021

Preprint

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“…Acetabular implant positioning was compared radiographically in 60 patients using supine versus lateral patient positioning through a modified Watson-Jones approach with more accurate cup positioning in the supine position. 13 Moon et al 14 compared two techniques of posterior soft tissue repair in 167 hips (150 patients) at a 28-month follow-up and reported better outcomes and less dislocations with trans-osseous repair compared with gluteus medius/short rotators tendon-to-tendon repair. Finally, Kruse et al 16 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 posterior compared with lateral approach.…”

Section: Resultsmentioning

confidence: 99%

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

Matar

Platt

Board³

et al. 2020

JAAOS Glob Res Rev

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Aim: To provide an overview of randomized controlled trials (RCTs) in primary total hip arthroplasty summarizing the available high-quality evidence. Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), we searched the Cochrane Central Register of Controlled Trials (2020, Issue 1), Ovid MEDLINE, and Embase. 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 (surgical approach, fixation, and component design use, among others). Results: Three hundred twelve RCTs met the inclusion criteria and were included. The total number of patients in those 312 RCTs was 34,020. Sixty-one RCTs (19.5%) reported significant differences between the intervention and the control groups. The trials were grouped into surgical approach 72, fixation 7, cement 16, femoral stem 46, head sizes 5, cup design 18, polyethylene 25, bearing surfaces 30, metal-on-metal 30, resurfacing 20, navigation 15, robotics 3, surgical technique 12, and closure/drains/postoperative care 13 RCTs. Discussion: The evidence reviewed indicates that for the vast majority of patients, a standard conventional total hip arthroplasty with a surgical approach familiar to the surgeon using standard well-established components and highly cross-linked polyethylene leads to satisfactory clinical outcomes. This evidence also offers arthroplasty surgeons the flexibility to use the standard and cost-effective techniques and achieve comparable outcomes.

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“…THAs were performed under spinal anaesthesia with intravenous sedation. All surgeries were performed via the minimally invasive anterolateral approach modifying the Watson-Jones approach with the patient in the supine or lateral position on a standard operating table [3,12,13] (Fig. 1).…”

Section: Surgical Proceduresmentioning

confidence: 99%

Incidence of tensor fascia lata muscle atrophy after using the modified Watson-Jones anterolateral approach in total hip arthroplasty

Takada

Jinno

Miyatake

et al. 2020

Eur J Orthop Surg Traumatol

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Background Post-operative tensor fascia lata (TFL) muscle atrophy due to superior gluteal nerve (SGN) injury during total hip arthroplasty (THA) can affect patients' post-operative hip function. This study aimed to determine the incidence of TFL muscle atrophy in THA performed via the modified Watson-Jones anterolateral approach and the risk factors for TFL atrophy. Methods We reviewed pre-and post-operative magnetic resonance imaging (MRI) data of 164 patients who underwent cementless THA via the modified Watson-Jones approach at one institution. TFL atrophy was defined as worsening of ≥ 2 grades in the Goutallier classification or > 40% decrease in the cross-sectional area (CSA) of the TFL on post-operative MRI compared to that on preoperative MRI. Patients' backgrounds were compared between those with or without TFL atrophy to determine the risk factors of TFL atrophy. Fatty atrophy grade and CSA of the gluteus minimus and medius were also evaluated. Results Thirteen (8.0%) cases of TFL atrophy were detected. The mean body mass index (BMI) in the cases with TFL atrophy was significantly higher than in those without TFL atrophy (p = 0.012). The fatty atrophy grade was worse post-operatively than preoperatively; moreover, the CSA of the gluteus minimus decreased. Conclusions We found a low incidence of TFL atrophy due to SGN injury after THA using the modified Watson-Jones approach. High BMI can be a risk factor for nerve injury. The gluteus minimus can be injured directly during surgery. We suggest that overexposure of the surgical site should be avoided, especially in patients with high BMI.

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Supine versus lateral position for accurate positioning of acetabular cup in total hip arthroplasty using the modified Watson-Jones approach: A randomized single-blind controlled trial

Cited by 29 publications

References 32 publications

The Accuracy And Influencing Factors of An Accelerometer-Based Portable Navigation System For Total Hip Arthroplasty In The Supine Position : A Prospective Multicenter Study Using 3D CT Measurement

The Accuracy And Influencing Factors of An Accelerometer-Based Portable Navigation System For Total Hip Arthroplasty In The Supine Position : A Prospective Multicenter Study Using 3D CT Measurement

Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?

Incidence of tensor fascia lata muscle atrophy after using the modified Watson-Jones anterolateral approach in total hip arthroplasty

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