Surgical approach for total hip arthroplasty: direct lateral or posterior?

Details

Serval ID
serval:BIB_72F5399655C3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Surgical approach for total hip arthroplasty: direct lateral or posterior?
Journal
Journal of Rheumatology
Author(s)
Jolles B.M., Bogoch E.R.
ISSN
0315-162X
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
31
Number
9
Pages
1790-1796
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis
Abstract
OBJECTIVE: To determine the risks of prosthesis dislocation, postoperative Trendelenburg gait, and sciatic nerve palsy after a posterior approach compared to a direct lateral approach for adult patients undergoing total hip arthroplasty (THA) for primary osteoarthritis (OA). METHODS: Medline, Embase, CINHAL, and Cochrane databases were searched until August 2003. All published trials comparing posterior and direct lateral surgical approaches to THA in adults with a diagnosis of primary hip osteoarthritis were collected. Retrieved articles were assessed independently for their methodological quality. RESULTS: Four prospective cohort studies involving 241 participants met the inclusion criteria. Regarding dislocation rate, no significant difference between posterior and direct lateral surgical approach was found (relative risk 0.35). The presence of postoperative Trendelenburg gait was not significantly different between surgical approaches. The risk of nerve palsy or injury was significantly higher with the direct lateral approach (relative risk 0.16). However, there were no significant differences when comparing this risk nerve by nerve, in particular for the sciatic nerve. Of the other outcomes considered, only the average range of internal rotation in extension of the hip was significantly higher (weighted mean difference 16 degrees ) in the posterior approach group (mean 35 degrees, SD 13 degrees ) compared to the direct lateral approach (mean 19 degrees, SD 13 degrees ). CONCLUSION: The quality and quantity of information extracted from the trials performed to date are insufficient to make a firm conclusion on the optimum choice of surgical approach for adult patients undergoing primary THA for OA.
Keywords
Arthroplasty, Replacement, Hip, Humans, Osteoarthritis, Hip, Postoperative Complications
Pubmed
Web of science
Create date
28/01/2008 13:19
Last modification date
20/08/2019 15:31
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