Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2023-01-01 DOI:10.1051/sicotj/2023008
Eustathios Kenanidis, Nikolaos Milonakis, Foukarakis Georgios, Michael Potoupnis, Eleftherios Tsiridis
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Abstract

Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon.

Methods: Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016-2017 and 2020-2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up.

Results: The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months.

Conclusions: The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure.

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与标准的直接上入路(DSA)相比,上横无创重建(STAR)入路提供了更好的结果:一项匹配的前瞻性单外科医生比较研究。
简介:直接上入路(DSA)是一种保留肌肉的髋关节入路,不保护梨状肌和其他短外旋肌。我们提出了一种DSA改良方法,我们命名为STAR(优越横向无创伤重建),它具有DSA优势,但总是保留梨状肌。我们的研究比较了通过STAR入路接受原发性全髋关节置换术(THA)的患者与由资深外科医生进行匹配的DSA组的早期术后、放射学和功能结果。方法:每组,DSA和STAR分别包括2016-2017年和2020-2021年期间由外科医生进行的200例选择性原发性单侧tha手术。两组患者采用相同的纳入标准。两组人的年龄和性别都是匹配的。两组均采用相同的术后疼痛管理、化学预防和物理治疗方案。两位独立的骨科医生进行了临床和放射学随访。结果:STAR组平均切口长度(p = 0.042)和住院时间(p = 0.002)明显低于DSA组。STAR组平均术中出血量(p = 0.085)和输血需要量(p = 0.228)均低于DSA组。术后第一个月和第三个月结束时,STAR组术后功能评分的平均改善明显高于DSA组。结论:与DSA相比,STAR方法可以更早地改善原发性THA患者的功能,缩短住院时间,减少输血需求。两种入路并发症风险均有限,且髋臼和股骨通路良好。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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