A Systematic Review of Functional Outcome after Lateral Surgical Approach for Total Hip Arthroplasty

Faisal Ma, Chowdhury Az, Kundu Ik, Mahmud Ci, Ali My, Runa Sp, Parajuli S, Amin Mr, Zawad M, Dey D, Choudhury Me
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Abstract

Introduction: Osteoarthritis affects 10% of the population, primarily affecting weight-bearing joints such the hips (5%) and other joints. A total hip arthroplasty (THA) is typically required (2.5% of persons between the ages of 40 and 84) as a result of worsening gait, rising pain, and stiffness. There have been many different surgical methods for the hip mentioned. The posterior and direct lateral approaches are currently the main THA techniques. The direct lateral method is said to have the advantage of allowing good acetabular exposure and simplifying cup alignment, which may lower hip dislocation rates. Additionally, it reduces the chance of damaging the sciatic nerve far from the surgical site. Materials and Methods: The prospective study on 25 patients with unilateral osteoarthritis, aged 25 to 60 years was carried out at Department of Orthopaedic surgery, Bangabandhu Sheikh Mujib Medical University and different private hospital at Dhaka, Bangladesh from September 2020 to March 2023 where outcome of uncemented THR by Direct Lateral approach was recorded. Evaluation of the results was done the day before the procedure as well as one month, three months, six months, and twelve months thereafter. Aim: The main objective was to find out functional outcome of patients after total hip arthroplasty by direct lateral approach. Results: Total 25 Patients with unilateral osteoarthritis have undergone uncemented total hip arthroplasty by Lateral approach, n= 25; 12(48%) were female and 13 (52%) were male. The mean age of patients was 42.5 years range from 25-60 years. Right Side was predominantly affected in all cases. VAS, HHS and WOMAC scores significantly improved at the follow-up after THA by the LA (all p < 0.05). A VAS score preoperatively was 8.7 which was improved 2.5 at 12 months follow up with significant p value <0.001. Conclusion: Patients who had Total Hip Arthroplasty performed with the Lateral Approach reported significiant improvement in functional outcomes with less postoperative muscle damage, stiffness, and pain during daily activities.
全髋关节置换术侧方手术入路后功能效果的系统回顾
导言:骨关节炎影响 10%的人口,主要影响负重关节,如髋关节(5%)和其他关节。由于步态恶化、疼痛加剧和僵硬,通常需要进行全髋关节置换术(THA)(2.5% 的 40 至 84 岁人群)。针对髋关节的手术方法有很多种。后路和直接外侧入路是目前主要的髋关节置换术(THA)技术。据说直接侧位法的优点是可以很好地暴露髋臼并简化髋臼杯的对位,从而降低髋关节脱位的发生率。此外,它还能减少在远离手术部位的地方损伤坐骨神经的机会。材料与方法:这项前瞻性研究于 2020 年 9 月至 2023 年 3 月在孟加拉国达卡班加班杜谢赫-穆吉布医科大学矫形外科系和不同的私立医院进行,对 25 名单侧骨关节炎患者(年龄在 25 岁至 60 岁之间)进行了研究,记录了采用直接外侧入路的非骨水泥全髋关节置换术的结果。对手术前一天、手术后一个月、三个月、六个月和十二个月的结果进行了评估。目的:主要目的是了解直接外侧入路全髋关节置换术后患者的功能效果。结果共有 25 名单侧骨关节炎患者接受了外侧入路非骨水泥全髋关节置换术,其中女性 12 人(48%),男性 13 人(52%)。患者平均年龄为 42.5 岁,从 25 岁到 60 岁不等。所有病例均以右侧受累为主。LA的VAS、HHS和WOMAC评分在THA术后随访中均有明显改善(P均<0.05)。术前的 VAS 评分为 8.7,随访 12 个月后提高了 2.5,P 值明显小于 0.001。结论采用外侧入路进行全髋关节置换术的患者术后肌肉损伤、僵硬感和日常活动疼痛明显减轻,功能明显改善。
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