Comparative study of radiological and functional outcomes following a direct anterior approach versus to a posterolateral approach to the hip

Autor: Martin Buttaro, Fernando Comba, A. Cid-Casteulani, D. Godoy-Monzon, A. Ordas, Francisco Piccaluga
Rok vydání: 2019
Předmět:
Zdroj: Revista Española de Cirugía Ortopédica y Traumatología (English Edition). 63:370-375
ISSN: 1988-8856
DOI: 10.1016/j.recote.2019.07.003
Popis: Objective To compare clinically and radiologically the results obtained using both a direct anterior approach (DAA) and posterolateral (PL) approach in total hip arthroplasty (THA). Material and methods Multicentric longitudinal prospective study in 80 patients (80 THA). Forty patients underwent total hip arthroplasty through DAA and 40 through a PL approach. The following clinical parameters were collected: anaesthesia, length of surgical incision, duration of the procedure, lower limb discrepancy, pain, complications, hospitalization time, Harris Hip Score (HHS) and subjective patient satisfaction. Radiological measures collected were acetabular tilt angle, acetabular component version, osteointegration and lower limb length. Results Postoperative pain DAA 4 points; PL 4.3 points. Incision length DAA 14 cm, PL 15 cm. Mean hospital stay DAA 2.8 days, PL 3.4 days. HHS at 3 weeks, DAA 87.5 and PL 84 points; at 2 months DAA was 92 and PL 91 points. Femoral stem subsidence was noticed in 4 patients from DAA and 1 from PL. Malalignment was reported in 9 cases from the DAA group. Conclusions Our results show an initial advantage of the DAA group regarding functional recovery and pain that enabled shorter hospitalization time. This difference equalled out over two months following the procedure. Likewise, we detected a greater complication rate in the DAA group using standard cementless stems.
Databáze: OpenAIRE
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