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BMC Musculoskeletal Disorders

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Open Access 01-12-2022 | Hip Dysplasia | Research

Direct anterior versus posteriorlateral approachs for clinical outcomes after total hip arthroplasty in the treatment of severe DDH

Authors: Yiping Lan, Eryou Feng, Bei Lin, Zhiming Lu, Feitai Lin, Yan Weng

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

The total hip arthroplasty (THA) has gained popularity in in the treatment of severe developmental dysplasia of the hip (DDH). the posterior lateral approach (PLA) has good clinical efficacy and has been confirmed by the majority clinicians. Nevertheless, controversy exists regarding longer-term benefits of the direct anterior approach (DAA). The objective of this study was to investigate the clinical efficacy and placement of S-ROM prosthesis in the treatment of severe DDH by The total hip arthroplasty (THA) with different surgical approaches.

Methods

A retrospective analysis was performed on 42 patients with severe DDH admitted to our hospital from August 2015 to February 2022, who were treated with S-ROM prosthesis for total hip arthroplasty and subtrochanteric osteotomy of the femur. They were divided into DAA group and PLA group according to different surgical approaches. Perioperative indicators and imaging data were collected.

Results

The surgery time, intraoperative blood loss, and creatine kinase difference in DAA group and PLA group was without a statistically significant difference (P > 0.05). The postoperative length of hospitalization was shorter in the DAA group than in the PLA group (6.50 ± 3.15 vs 9.18 ± 4.93, P = 0.045). The acetabular abduction angles、the acetabular anteversion angles, the safe area ratio, The difference of femoral eccentricity, and the vertical difference of rotation center in DAA group and PLA group, there was no statistical significance (P > 0.05). Statistically significant differences were detected the horizontal difference of rotation center (P = 0.044).

Conclusions

Total hip arthroplasty with S-ROM prosthesis is a feasible procedure for severe dysplastic DDH. The clinical efficacy and prosthesis placement parameters of DAA approach are advantage to those of PLA approach.

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Yang S, Zusman N, Lieberman E, Goldstein RY. Developmental dysplasia of the hip. Pediatrics. 2019;143(1):e20181147.CrossRefPubMed

Noble PC, Kamaric E, Sugano N, et al. Three-dimensional shape of the dysplastic femur: implications for THR. Clin Orthop Relat Res. 2003;(417):27–40.

Eskelinen A, Helenius I, Remes V, Ylinen P, Tallroth K, Paavilainen T. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J Bone Joint Surg Am. 2006;88(1):80–91.PubMed

Vanlommel J, Sutter M, Leunig M. Total hip arthroplasty using the direct anterior approach and intraoperative neurophysiological monitoring for Crowe III hip dysplasia : surgical technique and case series. Acta Orthop Belg. 2020;86(1):22–7.PubMed

Howie CR, Ohly NE, Miller B. Cemented total hip arthroplasty with subtrochanteric osteotomy in dysplastic hips. Clin Orthop Relat Res. 2010;468(12):3240–7.CrossRefPubMedPubMedCentral

Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61(1):15–23.CrossRefPubMed

Pesce V, Maccagnano G, Vicenti G, et al. First case report of vanadium metallosis after ceramic-on-ceramic total hip arthroplasty. J Biol Regul Homeost Agents. 2013;27(4):1063–8.PubMed

Matharu GS, Daniel J, Ziaee H, McMinn DJ. Failure of a novel ceramic-on-ceramic hip resurfacing prosthesis. J Arthroplast. 2015;30(3):416–8. https://doi.org/10.1016/j.arth.2014.10.019.CrossRef

Shi XT, Li CF, Han Y, Song Y, Li SX, Liu JG. Total hip arthroplasty for Crowe type IV hip dysplasia: surgical techniques and postoperative complications. Orthop Surg. 2019;11(6):966–73.CrossRefPubMedPubMedCentral

10.

Ma HY, Lu Q, Sun JY, et al. One-stage total hip arthroplasty with modular S-ROM stem for patients with bilateral Crowe type IV developmental dysplasia. Orthop Surg. 2020;12(6):1913–22.CrossRefPubMedPubMedCentral

11.

Takada R, Jinno T, Miyatake K, et al. Direct anterior versus anterolateral approach in one-stage supine total hip arthroplasty. Focused on nerve injury: a prospective, randomized, controlled trial. J Orthop Sci. 2018;23(5):783–7.CrossRefPubMed

12.

Meermans G, Konan S, Das R, Volpin A, Haddad FS. The direct anterior approach in total hip arthroplasty: a systematic review of the literature. Bone Joint J. 2017;99-B(6):732–40.CrossRefPubMed

13.

Wang S, Zhou Y, Ma H, Du Y, Piao S, Wu W. Mid-term results of total hip replacement with subtrochanteric osteotomy, modular stem, and ceramic surface in Crowe IV hip dysplasia. Arthroplast Today. 2017;4(3):363–9.CrossRefPubMedPubMedCentral

14.

Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–20.CrossRefPubMed

15.

Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Orthop Relat Res. 2016;474(2):386–91.CrossRefPubMed

16.

Wang D, Li LL, Wang HY, Pei FX, Zhou ZK. Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in Crowe type IV developmental dysplasia. J Arthroplast. 2017;32(4):1211–9.CrossRef

17.

Greber EM, Pelt CE, Gililland JM, Anderson MB, Erickson JA, Peters CL. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip. J Arthroplast. 2017;32(9S):S38–44.CrossRef

18.

Liu Z, Bell CD, Ong AC, Zhang J, Li J, Zhang Y. Clinical evaluation of direct anterior approach total hip arthroplasty for severe developmental dysplasia of the hip. Sci Rep. 2021;11(1):8105 Published 2021 Apr 14.CrossRefPubMedPubMedCentral

19.

Bernasek TL, Haidukewych GJ, Gustke KA, Hill O, Levering M. Total hip arthroplasty requiring subtrochanteric osteotomy for developmental hip dysplasia: 5- to 14-year results. J Arthroplast. 2007;22(6 Suppl 2):145–50.CrossRef

20.

Moazen M, Jones AC, Jin Z, Wilcox RK, Tsiridis E. Periprosthetic fracture fixation of the femur following total hip arthroplasty: a review of biomechanical testing. Clin Biomech (Bristol, Avon). 2011;26(1):13–22.CrossRefPubMed

21.

Yetkin C, Yildirim T, Alpay Y, Tas SK, Buyukkuscu MO, Dırvar F. Evaluation of dislocation risk factors with total hip arthroplasty in developmental hip dysplasia patients: a multivariate analysis. J Arthroplast. 2021;36(2):636–40.CrossRef

22.

Ding ZC, Zeng WN, Mou P, Liang ZM, Wang D, Zhou ZK. Risk of dislocation after total hip arthroplasty in patients with Crowe type IV developmental dysplasia of the hip. Orthop Surg. 2020;12(2):589–600.CrossRefPubMedPubMedCentral

23.

Shetty T, Nguyen JT, Wu A, et al. Risk factors for nerve injury after total hip arthroplasty: a case-control study. J Arthroplast. 2019;34(1):151–6.CrossRef

24.

Shubert D, Madoff S, Milillo R, Nandi S. Neurovascular structure proximity to acetabular retractors in total hip arthroplasty. J Arthroplast. 2015;30(1):145–8.CrossRef

25.

Schmalzried TP, Amstutz HC, Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis. J Bone Joint Surg Am. 1991;73(7):1074–80.CrossRefPubMed

26.

Simmons C Jr, Izant TH, Rothman RH, Booth RE Jr, Balderston RA. Femoral neuropathy following total hip arthroplasty. Anatomic study, case reports, and literature review. J Arthroplast. 1991;6 Suppl:S57–66.

27.

Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand. 1980;51(3):531–4.CrossRefPubMed

28.

Oldenburg M, Müller RT. The frequency, prognosis and significance of nerve injuries in total hip arthroplasty. Int Orthop. 1997;21(1):1–3.CrossRefPubMedPubMedCentral

29.

Shin WC, Lee SM, Lee KW, Cho HJ, Lee JS, Suh KT. The reliability and accuracy of measuring anteversion of the acetabular component on plain anteroposterior and lateral radiographs after total hip arthroplasty. Bone Joint J. 2015;97-B(5):611–6.CrossRefPubMed

30.

Park YS, Shin WC, Lee SM, Kwak SH, Bae JY, Suh KT. The best method for evaluating anteversion of the acetabular component after total hip arthroplasty on plain radiographs. J Orthop Surg Res. 2018;13(1):66 Published 2018 Apr 2.CrossRefPubMedPubMedCentral

31.

Lee GC, Lee SH, Kang SW, Park HS, Jo S. Accuracy of planar anteversion measurements using anteroposterior radiographs. BMC Musculoskelet Disord. 2019;20(1):586 Published 2019 Dec 5.CrossRefPubMedPubMedCentral

32.

Alzohiry MA, Abdelnasser MK, Moustafa M, et al. Accuracy of plain antero-posterior radiographic-based methods for measurement of acetabular cup version. Int Orthop. 2018;42(12):2777–85.CrossRefPubMed

33.

Nho JH, Lee YK, Kim HJ, Ha YC, Suh YS, Koo KH. Reliability and validity of measuring version of the acetabular component. J Bone Joint Surg Br. 2012;94(1):32–6.CrossRefPubMed

Title: Direct anterior versus posteriorlateral approachs for clinical outcomes after total hip arthroplasty in the treatment of severe DDH
Authors: Yiping Lan
Eryou Feng
Bei Lin
Zhiming Lu
Feitai Lin
Yan Weng
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Hip Dysplasia
Hip-TEP
Hip-TEP
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05759-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Direct anterior versus posteriorlateral approachs for clinical outcomes after total hip arthroplasty in the treatment of severe DDH

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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