Surgical approach and prosthesis fixation in hip arthroplasty world wide

Abstract

The most common surgical approaches in use in hip arthroplasty are posterior and lateral. Anterior approach is used by a minority of orthopedic surgeons for that purpose. Cementing hip prosthesis is falling out of favor among orthopedic surgeons worldwide. The trend toward un-cemented hip arthroplasty is not well supported in the current literature.

The choice of approach in total hip arthroplasty, does it really matters?

“…The rate of dislocation and fracture did not differ significantly between the groups. [25][26][27] Harris hip score in our study also favors that there is no significant difference with either approach. A common comparator between the posterior and lateral approach is the incidence of abductor insufficiency.…”

Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

“…3 Internationally, this approach is gaining popularity in the hip arthroplasty community. 4 Advocates of this approach consider its advantages to be the muscle-sparing nature of its internervous intervals, earlier restoration of gait kinematics and low dislocation rates. [5][6][7][8][9] The direct anterior approach can be performed with or without the use of a specialized table or fluoroscopy.…”

“…12 A recent survey of surgeons from around the world suggests that the posterior approach is the most common surgical approach used internationally for THAs. 4 In Canada, about 36% of arthroplasty surgeons use this approach.…”

“…4 Reduced blood loss, earlier functional recovery, low dislocation rates and shorter stays in hospital have been attributed to the muscle-sparing properties of the anterior approach. 6 The literature also suggests that minimizing muscle damage during surgery is a reason for patients to choose particular surgeons who practise muscle-sparing techniques.…”

Artroplastia Total da Anca: Estudo Retrospetivo e Comparativo entre a Abordagem Anterior Direta e a Abordagem Posterior

“…A base teórica para a sua utilização faz sentido para a maioria dos especialistas, sendo necessários, no entanto, estudos que determinem em quem deve ser aplicada e que comprovem completamente a sua superioridade. 24 A melhoria sugerida pelos nossos resultados, sobretudo ao nível do ângulo acetabular na AAD, vai de encontro ao publicado anteriormente. 6 A posição supina do doente durante a cirurgia possibilita a utilização facilitada do fluoroscópio, sendo este o principal fator descrito para esta diferença.…”