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01-12-2015 | Original Paper

Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty

Authors: Johannes C. Reichert, Maximilian R. Volkmann, Maximilian Koppmair, Lars Rackwitz, Martin Lüdemann, Maximilian Rudert, Ulrich Nöth

Published in: International Orthopaedics | Issue 12/2015

Abstract

Purpose

The presented retrospective study compares clinical outcomes five years after total hip arthroplasty performed through a minimally invasive direct anterior approach and a direct transgluteal lateral approach.

Methods

A total of 171 arthroplasties in 167 patients were evaluated utilizing the Harris hip score (HHS), the SF-36, a daily activity questionnaire, and the UCLA activity score.

Results

The average HHS showed no significant difference equalling 91.4 points in the anterior group and 92.4 in the lateral group (p = 0.952). The SF-36 physical component scores were 50.7 (anterior) and 50.0 (lateral) while the psychometric properties added up to 48.6 (anterior) and 50.3 (lateral) with no significant differences evident (p = 0.782, p = 0.071). Daily activity was found to result in 4,855 (anterior) and 5,016 (lateral) cycles, respectively (p = 0.364). No difference regarding pain sensation was determined (p = 0.859). A significant difference was found for the UCLA score, which was calculated to be 5.9 in the anterior and 6.4 in the lateral approach group (p = 0.008).

Conclusion

In summary, our mid-term results show comparable outcomes for both approaches regarding functionality, pain, quality of life and daily activity.

Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP (2005) Minimally invasive total hip arthroplasty: a prospective randomized study. J Arthroplasty 20(2):139–144CrossRefPubMed

Goebel S, Steinert AF, Schillinger J, Eulert J, Broscheit J, Rudert M, Noth U (2012) Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach. Int Orthop 36(3):491–498. doi:10.1007/s00264-011-1280-0 PubMedCentralCrossRefPubMed

Noth U, Nedopil A, Holzapfel BM, Koppmair M, Rolf O, Goebel S, Eulert J, Rudert M (2012) Minimally invasive anterior approach. Orthopade 41(5):390–398. doi:10.1007/s00132-011-1894-3 CrossRefPubMed

Rachbauer F (2005) Minimally invasive total hip arthroplasty via direct anterior approach. Orthopade 34(11):1103–1104. doi:10.1007/s00132-005-0854-1, 1106–1108, 1110CrossRefPubMed

Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–49CrossRefPubMed

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755PubMed

Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R (2002) Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ 324(7351):1417PubMedCentralCrossRefPubMed

Wollmerstedt N, Noth U, Ince A, Ackermann H, Martell JM, Hendrich C (2010) The daily activity questionnaire: a novel questionnaire to assess patient activity after total hip arthroplasty. J Arthroplasty 25(3):475–480. doi:10.1016/j.arth.2009.01.005, e471-473CrossRefPubMed

Naal FD, Impellizzeri FM, Leunig M (2009) Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res 467(4):958–965. doi:10.1007/s11999-008-0358-5 PubMedCentralCrossRefPubMed

10.

Johnston RC, Fitzgerald RH Jr, Harris WH, Poss R, Muller ME, Sledge CB (1990) Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg Am 72(2):161–168PubMed

11.

Dorr LD, Maheshwari AV, Long WT, Wan Z, Sirianni LE (2007) Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study. J Bone Joint Surg Am 89(6):1153–1160. doi:10.2106/JBJS.F.00940 CrossRefPubMed

12.

Jacquot F, Ait Mokhtar M, Sautet A, Doursounian L, Masquelet AC, Feron JM (2013) The mini postero-postero-lateral mini incision in total hip arthroplasty. Int Orthop 37(10):1891–1895. doi:10.1007/s00264-013-1970-x PubMedCentralCrossRefPubMed

13.

Restrepo C, Parvizi J, Pour AE, Hozack WJ (2010) Prospective randomized study of two surgical approaches for total hip arthroplasty. J Arthroplasty 25(5):671–679. doi:10.1016/j.arth.2010.02.002, e671CrossRefPubMed

14.

Dienstknecht T, Luring C, Tingart M, Grifka J, Sendtner E (2013) A minimally invasive approach for total hip arthroplasty does not diminish early post-operative outcome in obese patients: a prospective, randomised trial. Int Orthop 37(6):1013–1018. doi:10.1007/s00264-013-1833-5 PubMedCentralCrossRefPubMed

15.

Pour AE, Parvizi J, Sharkey PF, Hozack WJ, Rothman RH (2007) Minimally invasive hip arthroplasty: what role does patient preconditioning play? J Bone Joint Surg Am 89(9):1920–1927. doi:10.2106/JBJS.F.01153 CrossRefPubMed

16.

Barrett WP, Turner SE, Leopold JP (2013) Prospective randomized study of direct anterior vs postero-lateral approach for total hip arthroplasty. J Arthroplasty 28(9):1634–1638. doi:10.1016/j.arth.2013.01.034 CrossRefPubMed

17.

Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13(8):890–895CrossRefPubMed

18.

Beverland D (2011) Approaches. In: Vidalain J-P, Selmi TAS, Beverland D et al (eds) The Corail® hip system. Springer Berlin Heidelberg, Heidelberg, pp 193–216. doi:10.1007/978-3-642-18396-6_6 CrossRef

19.

Bhargava T, Goytia RN, Jones LC, Hungerford MW (2010) Lateral femoral cutaneous nerve impairment after direct anterior approach for total hip arthroplasty. Orthopedics 33(7):472. doi:10.3928/01477447-20100526-05 PubMed

20.

Smith TO, Blake V, Hing CB (2011) Minimally invasive versus conventional exposure for total hip arthroplasty: a systematic review and meta-analysis of clinical and radiological outcomes. Int Orthop 35(2):173–184. doi:10.1007/s00264-010-1075-8 PubMedCentralCrossRefPubMed

21.

Aszmann OC, Dellon ES, Dellon AL (1997) Anatomical course of the lateral femoral cutaneous nerve and its susceptibility to compression and injury. Plast Reconstr Surg 100(3):600–604CrossRefPubMed

22.

Hoberg M, Rudert M, Tillmann B (2012) Minimally invasive hip arthroplasty—what must be spared? Orthopade 41(5):338–345. doi:10.1007/s00132-011-1888-1 CrossRefPubMed

23.

Yi C, Agudelo JF, Dayton MR, Morgan SJ (2013) Early complications of anterior supine intermuscular total hip arthroplasty. Orthopedics 36(3):e276–e281. doi:10.3928/01477447-20130222-14 CrossRefPubMed

Title: Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty
Authors: Johannes C. Reichert
Maximilian R. Volkmann
Maximilian Koppmair
Lars Rackwitz
Martin Lüdemann
Maximilian Rudert
Ulrich Nöth
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 12/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2732-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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