The effect of 3 commonly used surgical approaches for total hip arthroplasty on mid- to long-term patient-reported outcome measures.

Autor:	Rhee I; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Tirosh O; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia.; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Victoria University, St. Albans, VIC, Australia., Ho A; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Griffith A; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Salehi L; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Jensen A; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Spiers L; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia., Tran P; Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia.; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Victoria University, St. Albans, VIC, Australia.; Swinburne University of Technology, Melbourne, VIC, Australia.
Jazyk:	angličtina
Zdroj:	Hip international : the journal of clinical and experimental research on hip pathology and therapy [Hip Int] 2024 Mar; Vol. 34 (2), pp. 161-167. Date of Electronic Publication: 2023 Sep 25.
DOI:	10.1177/11207000231199342
Abstrakt:	Introduction: The most effective surgical approach for total hip arthroplasty (THA) remains controversial. Comparisons of surgical approach based on patient-reported outcome measures (PROMs) have been limited to short- to mid-term outcomes or the comparison of only 2 approaches. The aim of this study was to compare PROMs for the 3 main approaches for THA with up to 10 years follow-up. Methods: A total of 906 patients who underwent primary THA at a single hospital between 2009 and 2020 through an anterior (312), lateral (211) or posterior (383) approach were evaluated using the Oxford Hip Score (OHS), EuroQoL-5-Dimension (EQ-5D-5L) and visual analogue scale/verbal rating scale for pain (VAS/VRS). PROMs were prospectively collected before surgery and routinely at 6 weeks, 6 months and 1, 2, 5 and 10 years after surgery. Results: There was no significant difference in demographics or comorbidities between the 3 groups. All 3 approaches resulted in a significant improvement in overall PROMs after THA, and plateaued after 6 months postoperatively, with no difference between the approaches (OHS, p  < 0.01;EQ-5D-5L Index, p  < 0.01;VAS/VRS, p  < 0.01). The EQ-5D-5L mobility dimension showed that the lateral approach resulted in 20% more patients reporting problems with mobility than the posterior and anterior approaches at the 6-week, 6-month, 2-year and 10-year follow-up. Conclusions: This study shows that all 3 common THA approaches substantially and similarly improve the OHS, EQ-5D-5L Index and VRS between 6 months and 10 years postoperatively. However, patient-reported mobility was poorer after a lateral approach and continued to be so at long-term follow-up. Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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