Isa-Maturana A, Fernández-Palomo L

Language: Spanish
References: 15
Page: 239-247
PDF size: 913.07 Kb.

ABSTRACT

Introduction: the type of surgical approach in total hip arthroplasty can have a significant impact on patients' quality of life and reintegration into their daily lives. Material and methods: an analytical, longitudinal, observational, and prospective study was conducted with patients over 18 years of age, of both sexes, and metabolically stable, undergoing total hip arthroplasty scheduled for an anterior or lateral approach. Age, sex, weight, height, BMI, substance abuse, laterality of the injury, duration of injury, return to daily activities with the Technology-Activities of Daily Living Questionnaire (T-ADLQ), and functional capacity with the Harris Hip Score (HHS) were analyzed. Results were compared according to the approach. Results: 179 patients, 105 with DLA and 63 with DAA; 87 women and 92 men, age was 69.0 years [IQR 66.0-77.0], the left hip was the most affected. In the baseline T-ADLQ, they had 43.7 ± 6.5 points (DAA) and 40.9 ± 6.4 (ALD) (p = 0.007). At follow-up they had 39.0 ± 6.3 points and 36.6 ± 6.5, respectively (p = 0.020). In the domains, there were significant differences in self-care, home and travel, both at baseline and follow-up. In the baseline HHS, the most frequent result was poor in both (p = 0.231), at follow-up in both the result was good (p = 0.549). Conclusion: both approaches were effective for functional capacity and return to activities in patients undergoing total hip arthroplasty.

REFERENCES

1. Yue C, Kang P, Pei F. Comparison of direct anterior and lateral approaches in total hip arthroplasty: a systematic review and meta-analysis (PRISMA). Medicine (Baltimore). 2015; 94(50): e2126.

2. Colombi A, Schena D, Castelli CC. Total hip arthroplasty planning. EFORT Open Rev. 2019; 4(11): 626-32.

3. Neuprez A, Neuprez AH, Kaux JF, Kurth W, Daniel C, Thirion T, et al. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to five years. Clin Rheumatol. 2020; 39(3): 861-71.

4. Moretti VM, Post ZD. Surgical Approaches for Total Hip Arthroplasty. Indian J Orthop. 2017; 51(4): 368-76.

5. McLawhorn AS, Christ AB, Morgenstern R, Burge AJ, Alexiades MM, Su EP. Prospective evaluation of the posterior tissue envelope and anterior capsule after anterior total hip arthroplasty. J Arthroplasty. 2020; 35(3): 767-73.

6. Meneghini RM, Pagnano MW, Trousdale RT, Hozack WJ. Muscle damage during MIS total hip arthroplasty: Smith-Peterson versus posterior approach. Clin Orthop Relat Res. 2006; 453: 293-8.

7. Eto S, Hwang K, Huddleston JI, Amanatullah DF, Maloney WJ, Goodman SB. The direct anterior approach is associated with early revision total hip arthroplasty. J Arthroplasty. 2017; 32(3): 1001-5.

8. Graves SC, Dropkin BM, Keeney BJ, Lurie JD, Tomek IM. Does surgical approach affect patient-reported function after primary THA? Clin Orthop Relat Res. 2016; 474(4): 971-81.

9. Hart A, Wyles CC, Abdel MP, Perry KI, Pagnano MW, Taunton MJ. Thirty-day major and minor complications following total hip arthroplasty—a comparison of the direct anterior, lateral, and posterior approaches. J Arthroplasty. 2019; 34(11): 2681-5.

10. Radoicic D, Zec V, Elassuity WI, Azab MA. Patient's perspective on direct anterior versus posterior approach total hip arthroplasty. Int Orthop. 2018; 42(12): 2771-5.

11. Miller LE, Gondusky JS, Bhattacharyya S, Kamath AF, Boettner F, Wright J. Does surgical approach affect outcomes in total hip arthroplasty through 90 days of follow-up? A systematic review with meta-analysis. J Arthroplasty. 2018; 33(4): 1296-302.

12. Putananon C, Tuchinda H, Arirachakaran A, Wongsak S, Narinsorasak T, Kongtharvonskul J. Comparison of direct anterior, lateral, posterior and posterior-2 approaches in total hip arthroplasty: network meta-analysis. Eur J Orthop Surg Traumatol. 2018; 28(2): 255-67.

13. Makhdom AM, Hozack WJ. Direct anterior versus direct lateral hip approach in total hip arthroplasty with the same perioperative protocols one year post fellowship training. J Orthop Surg Res. 2023; 18(1): 216.

14. Yang M, Yao M, Chu K, Wei C, Li Z, Huo J, et al. Efficacy of direct anterior approach versus posterior lateral approach for total hip replacement in patients with Parkinson's disease. Med Sci Monit. 2023; 29: e939682. doi: 10.12659/MSM.939682.

15. Innocenti M, Cozzi Lepri A, Civinini A, Mondanelli N, Matassi F, Stimolo D, et al. Functional outcomes of anterior-based muscle sparing approach compared to direct lateral approach for total HIP arthroplasty following acute femoral neck fractures. Geriatr Orthop Surg Rehabil. 2023; 14: 21514593231170844. doi: 10.1177/21514593231170844.

EVIDENCE LEVEL

I