Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study
Abstract Purpose The aim of this study is to compare mid-term clinical outcome of direct superior approach (DSA) and posterolateral approach (PLA) in THA. Method Seventy-eight patients who underwent THA from January 2021 to June 2021 were prospectively enrolled and randomly allocated into DSA group...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-024-08271-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832572065798946816 |
|---|---|
| author | Zhanqi Wei Yiming Xu Wei Zhu Xisheng Weng Bin Feng |
| author_facet | Zhanqi Wei Yiming Xu Wei Zhu Xisheng Weng Bin Feng |
| author_sort | Zhanqi Wei |
| collection | DOAJ |
| description | Abstract Purpose The aim of this study is to compare mid-term clinical outcome of direct superior approach (DSA) and posterolateral approach (PLA) in THA. Method Seventy-eight patients who underwent THA from January 2021 to June 2021 were prospectively enrolled and randomly allocated into DSA group and PLA group. The surgical duration, incision length, total blood loss, ambulation time, visual analogue scale (VAS), patient satisfaction, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, postoperative leg length discrepancy (LLD), abduction angle, anteversion angle and complications were compared between the two groups. Results Thirty three patients were randomized to the PLA group and 32 patients allocated to the DSA group. The average follow-up period was 39.8 months in DSA group and 40.1 months in PLA group. Compared with PLA group, DSA group had longer surgical duration ([124.1 ± 11.2] min vs. [103.3 ± 20.7] min), less total blood loss ([482.4 ± 236.1] ml vs. [680.2 ± 299.4] ml), shorter incision ([8.7 ± 1.9] cm vs. [15.6 ± 1.7] cm), and earlier ambulation time ([15.8 ± 4.0] h vs. [20.5 ± 3.5] h), with statistically significant differences (P < 0.0001). Furthermore, the DSA group had significantly lower WOMAC Scores compared to the PLA group at 1-year postoperatively (P = 0.011), and had significantly lower WOMAC Function Scores and WOMAC Stiffness Scores both at 1-year postoperatively and at the last follow-up. The anteversion angle of the cup in the DSA Group was significantly smaller than the PLA Group at postoperative day (POD) 3 and the last follow-up (P = 0.006 and P = 0.010, respectively). However, there was no difference in postoperative patient satisfaction, complication, LLD or HHS between the two groups. Conclusion DSA demonstrated benefits in terms of reduced blood loss, improved pain scores, shorter incisions, and earlier ambulation. These advantages support the use of DSA for promoting early recovery and better mid-term functional outcomes. Trial registration The study protocol was registered on Chinese Clinical Trial Register (ChiCTR) with the register number ChiCTR2000041186 (registration date: 2020/12/21). |
| format | Article |
| id | doaj-art-4c1987f65b904100b2b5e4a31b3b23e0 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-4c1987f65b904100b2b5e4a31b3b23e02025-02-02T12:05:38ZengBMCBMC Musculoskeletal Disorders1471-24742025-01-0126111110.1186/s12891-024-08271-7Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled studyZhanqi Wei0Yiming Xu1Wei Zhu2Xisheng Weng3Bin Feng4Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Purpose The aim of this study is to compare mid-term clinical outcome of direct superior approach (DSA) and posterolateral approach (PLA) in THA. Method Seventy-eight patients who underwent THA from January 2021 to June 2021 were prospectively enrolled and randomly allocated into DSA group and PLA group. The surgical duration, incision length, total blood loss, ambulation time, visual analogue scale (VAS), patient satisfaction, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, postoperative leg length discrepancy (LLD), abduction angle, anteversion angle and complications were compared between the two groups. Results Thirty three patients were randomized to the PLA group and 32 patients allocated to the DSA group. The average follow-up period was 39.8 months in DSA group and 40.1 months in PLA group. Compared with PLA group, DSA group had longer surgical duration ([124.1 ± 11.2] min vs. [103.3 ± 20.7] min), less total blood loss ([482.4 ± 236.1] ml vs. [680.2 ± 299.4] ml), shorter incision ([8.7 ± 1.9] cm vs. [15.6 ± 1.7] cm), and earlier ambulation time ([15.8 ± 4.0] h vs. [20.5 ± 3.5] h), with statistically significant differences (P < 0.0001). Furthermore, the DSA group had significantly lower WOMAC Scores compared to the PLA group at 1-year postoperatively (P = 0.011), and had significantly lower WOMAC Function Scores and WOMAC Stiffness Scores both at 1-year postoperatively and at the last follow-up. The anteversion angle of the cup in the DSA Group was significantly smaller than the PLA Group at postoperative day (POD) 3 and the last follow-up (P = 0.006 and P = 0.010, respectively). However, there was no difference in postoperative patient satisfaction, complication, LLD or HHS between the two groups. Conclusion DSA demonstrated benefits in terms of reduced blood loss, improved pain scores, shorter incisions, and earlier ambulation. These advantages support the use of DSA for promoting early recovery and better mid-term functional outcomes. Trial registration The study protocol was registered on Chinese Clinical Trial Register (ChiCTR) with the register number ChiCTR2000041186 (registration date: 2020/12/21).https://doi.org/10.1186/s12891-024-08271-7Total hip arthroplastyDirect superior approachPosterolateral approachMid-term outcome |
| spellingShingle | Zhanqi Wei Yiming Xu Wei Zhu Xisheng Weng Bin Feng Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study BMC Musculoskeletal Disorders Total hip arthroplasty Direct superior approach Posterolateral approach Mid-term outcome |
| title | Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study |
| title_full | Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study |
| title_fullStr | Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study |
| title_full_unstemmed | Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study |
| title_short | Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study |
| title_sort | direct superior approach versus posterolateral approach in mid term clinical outcomes of total hip arthroplasty a prospective randomized controlled study |
| topic | Total hip arthroplasty Direct superior approach Posterolateral approach Mid-term outcome |
| url | https://doi.org/10.1186/s12891-024-08271-7 |
| work_keys_str_mv | AT zhanqiwei directsuperiorapproachversusposterolateralapproachinmidtermclinicaloutcomesoftotalhiparthroplastyaprospectiverandomizedcontrolledstudy AT yimingxu directsuperiorapproachversusposterolateralapproachinmidtermclinicaloutcomesoftotalhiparthroplastyaprospectiverandomizedcontrolledstudy AT weizhu directsuperiorapproachversusposterolateralapproachinmidtermclinicaloutcomesoftotalhiparthroplastyaprospectiverandomizedcontrolledstudy AT xishengweng directsuperiorapproachversusposterolateralapproachinmidtermclinicaloutcomesoftotalhiparthroplastyaprospectiverandomizedcontrolledstudy AT binfeng directsuperiorapproachversusposterolateralapproachinmidtermclinicaloutcomesoftotalhiparthroplastyaprospectiverandomizedcontrolledstudy |