Direct anterior versus posterior approach for total hip arthroplasty: a multicentre, prospective, randomized clinical trial.

Details

Serval ID
serval:BIB_961D109F1D42
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Direct anterior versus posterior approach for total hip arthroplasty: a multicentre, prospective, randomized clinical trial.
Journal
Canadian journal of surgery. Journal canadien de chirurgie
Author(s)
Moerenhout K., Derome P., Laflamme G.Y., Leduc S., Gaspard H.S., Benoit B.
ISSN
1488-2310 (Electronic)
ISSN-L
0008-428X
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
63
Number
5
Pages
E412-E417
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
The ideal approach for a total hip arthroplasty (THA) would be kind to soft tissues, have the lowest complication rates and be easily reproducible. Although there have been several attempts to find the best approach for THA in the last decade, a definitive answer has not been found. We performed a prospective study to compare the direct anterior and posterior approaches for THA in terms of hospital length of stay, functional outcome, pain, implant position, complications and surgical time.
A prospective, randomized, multicentre clinical study was conducted between February 2011 and July 2013, with an average follow-up of 55 months. Patients undergoing the direct anterior or posterior approach for THA were enrolled. Hospital length of stay, surgical time and complications were documented. The Harris Hip Score and visual analogue scale were used to monitor functional outcome and pain until 5 years postoperatively. Radiologic analysis was used to assess implant position.
Fifty-five patients (28 undergoing the direct anterior approach, 27 undergoing the posterior approach) were enrolled in this study. Length of stay, functional outcome, pain, implant position and complications were similar for the 2 approaches. There was a trend toward a better functional outcome for patients who underwent the direct anterior approach in the first 3 months postoperatively, with a peak at 4 weeks (Harris Hip Score 76.7 v. 68.7; p = 0.08). Average surgical time for the direct anterior approach was significantly longer (69.9 v. 45.7 min; p = 0.002).
The direct anterior approach for THA appears to be a safe and effective option. However, there is no significant difference in hospital length of stay or postoperative recovery between the 2 approaches.
Clinicaltrials.gov, no. NCT03673514.
Keywords
Aged, Arthroplasty, Replacement, Hip/adverse effects, Arthroplasty, Replacement, Hip/instrumentation, Arthroplasty, Replacement, Hip/methods, Arthroplasty, Replacement, Hip/statistics & numerical data, Female, Follow-Up Studies, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Operative Time, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Prospective Studies, Recovery of Function, Time Factors, Treatment Outcome
Pubmed
Web of science
Create date
09/10/2020 14:27
Last modification date
22/06/2022 6:38
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