Component Placement in Direct Lateral vs Minimally Invasive Anterior Approach in Total Hip Arthroplasty: Radiographic Outcomes From a Prospective Randomized Controlled Trial
| Autor: | Ole-Christian L. Brun, Knut Erik Mjaaland, Stephan M. Röhrl, Lars Nordsletten, Helge N. Sund |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiography Arthroplasty Replacement Hip Population Reference range Prosthesis Design Osteoarthritis Hip Patient Positioning law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial Double-Blind Method law Medicine Humans Orthopedics and Sports Medicine Femur Prospective Studies education Aged Hip surgery Aged 80 and over 030222 orthopedics education.field_of_study biology business.industry Norway Bone Cements Acetabulum Middle Aged biology.organism_classification Confidence interval Surgery Leg Length Inequality Valgus Female Hip Joint Hip Prosthesis business Body mass index |
| Zdroj: | The Journal of arthroplasty. 34(8) |
| ISSN: | 1532-8406 |
| Popis: | BACKGROUND End-stage coxarthrosis is increasingly common; however, limited evidence exists on the effect of direct lateral approach (DLA) and minimally invasive direct anterior approach (MIDA) on component placement in total hip arthroplasty (THA). We therefore conducted a prospective, randomized controlled trial to determine the component placement in DLA vs MIDA in THA. METHODS Between January 2012 and June 2013, 164 patients with clinically and radiologically confirmed coxarthrosis aged 20-80 years were randomized to either DLA or MIDA (active comparator). Excluded were patients with previous ipsilateral hip surgery, a body mass index >35 kg/m2, and/or mental disability. Primary clinical outcomes have been published elsewhere. Secondary outcomes included radiographic assessment of the acetabular component (cement-mantle thickness, inclination, and anteversion), femoral stem position (varus/valgus and THA index), offset restoration, and leg length discrepancy. RESULTS The mean cement-mantle was significantly thicker in zone 1 in the MIDA group (mean difference = 0.51 mm, 95% confidence interval [CI] 0.09-0.93, P = .018), and the mean degrees of inclination and anteversion were higher in the MIDA group (mean difference = 2.5°, 95% CI 0.3-4.6, P = .023 and mean difference = 3.6°, 95% CI 2.2-5.0, P < .0001, respectively). According to the defined reference range, cup inclination was more often adequate in the DLA group (67.9% (53/78) in the DLA group vs 52.4% (43/82) in the MIDA group, P = .045). There were no differences in frontal or lateral femoral stem position, global offset restoration, or leg length discrepancy. CONCLUSION In this population of Norwegian patients with coxarthrosis, radiographic assessment showed limited differences in component placement between MIDA and DLA. The findings suggest that component placement is similar in the 2 surgical approaches. |
| Databáze: | OpenAIRE |
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