Does the utilization of fluoroscopy affect the accuracy of prosthesis position in patients undergoing hip replacement surgery via the direct anterior approach compared to the posterolateral approach for an experienced surgeon? A single-center retrospective study.

Autor: Wu PK; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan., Chang WS; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan., Chen KT; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan., Huang PC; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan., Ho CH; Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan., Chien CS; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan., Wu TM; Department of Orthopedic Surgery, Chi-Mei Medical Center, No. 901., ChungHua Road, YongHang District, Tainan, Taiwan. wtm6896@gmail.com.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Oct 15; Vol. 25 (1), pp. 816. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1186/s12891-024-07917-w
Abstrakt: Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) has gained popularity due to perceived advantages in achieving better early outcomes. However, the theoretical benefits such as precise implant positioning and accurate leg length restoration are still inconsistent. In this study, we compared implant position and leg length discrepancy (LLD) of the DAA and posterolateral approach (PLA) conducted by a single surgeon who had mastered both approaches.
Methods: This study retrospectively reviewed the medical records and radiographic images of 244 patients who underwent THA between 2012 and 2021 by a single experienced surgeon using either the DAA (n = 120) or PLA (n = 124). Postoperative pelvic anteroposterior radiographs at 6 months follow-up were used to assess acetabular component inclination and anteversion, as well as LLD. Mann-Whitney U tests and Chi-squared test were performed to compare outcomes between the two approaches.
Results: No significant differences were observed in patient demographics between the two groups. The DAA group demonstrated significantly lower postoperative LLD (0.00 mm) compared to the PLA group (5.00 mm, p < 0.0001). No significant difference was observed in the Lewinnek zone for cup anteversion and inclination angles between the two groups.
Conclusions: For experienced surgeons in other approaches, our findings suggest transferring to the DAA may not substantially improve cup positioning, but it might slightly enhance limb length measurement. For surgeons already proficient in other approaches and deciding to maintain those approaches, their primary concern for optimal THA outcome should be striving for leg length equivalence.
(© 2024. The Author(s).)
Databáze: MEDLINE
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