Hip & pelvis最新文献

{"title":"The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes.","authors":"Tyler J Humphrey,&nbsp;Colin M Baker,&nbsp;Paul M Courtney,&nbsp;Wayne G Paprosky,&nbsp;Hany S Bedair,&nbsp;Neil P Sheth,&nbsp;Christopher M Melnic","doi":"10.5371/hp.2023.35.2.122","DOIUrl":"https://doi.org/10.5371/hp.2023.35.2.122","url":null,"abstract":"<p><strong>Purpose: </strong>The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique.</p><p><strong>Materials and methods: </strong>A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired.</p><p><strong>Results: </strong>The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement.</p><p><strong>Conclusion: </strong>Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 2","pages":"122-132"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/10/hp-35-122.PMC10264228.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9654867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Spinopelvic Parameters and Hip Function in Patients with Femoroacetabular Impingement at Diagnosis: A Cross-Sectional Study.","authors":"Bernardo Aguilera-Bohórquez,&nbsp;Pablo Corea,&nbsp;Cristina Sigüenza,&nbsp;Jochen Gerstner-Saucedo,&nbsp;Alvaro Carvajal,&nbsp;Erika Cantor","doi":"10.5371/hp.2023.35.1.6","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine correlation between the spinopelvic parameters in sitting and standing positions (sacral slope [SS], lumbar lordosis [LL], spinopelvic tilt [SPT], pelvic incidence [PI], and pelvic femoral angle [PFA]), with hip function assessed using the modified Harris hip scores (mHHs) in patients with symptomatic femoroacetabular impingement (FAI) at diagnosis.</p><p><strong>Materials and methods: </strong>A retrospective study of 52 patients diagnosed with symptomatic FAI was conducted. Evaluation of the spinopelvic complex in terms of SS, LL, SPT, PI and PFA was performed using lateral radiographs of the pelvis and lumbosacral spine in standing and sitting positions. Assessment of hip function at diagnosis was performed using the mHHs. Calculation of spinopelvic mobility was based on the difference (Δ) between measurements performed in standing and sitting position.</p><p><strong>Results: </strong>The median time of pain evolution was 11 months (interquartile range [IQR], 5-24 months) with a median mHHs of 66.0 points (IQR, 46.0-73.0) at diagnosis. The mean change of LL, SS, SPT, and PFA was 20.9±11.2°, 14.2±8.6°, 15.5±9.0°, and 70.7±9.5°, respectively. No statistically significant correlation was observed between spinopelvic parameters and the mHHs (<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Radiological parameters of the spinopelvic complex did not show correlation with hip function at the time of diagnosis in patients with symptomatic FAI. Conduct of further studies will be required in the effort to understand the effect of the spinopelvic complex and its compensatory mechanics, primarily between the hip and spine, in patients with FAI before and after hip arthroscopy.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/81/hp-35-6.PMC10020734.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9515016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking beyond Piriformis Syndrome: Is It Really the Piriformis?","authors":"Shivam Sharma,&nbsp;Harmanpreet Kaur,&nbsp;Nishank Verma,&nbsp;Bibek Adhya","doi":"10.5371/hp.2023.35.1.1","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.1","url":null,"abstract":"<p><p>Piriformis syndrome is a common differential diagnosis related to sciatica. The following review provides a concise synopsis of the diagnosis, management, history, and alternatives to diagnosis of piriformis syndrome. A search of the literature for research articles related to piriformis syndrome and associated differential diagnosis of sciatica was conducted. A thorough review of the included articles found that the condition known as piriformis syndrome is over-diagnosed and that potential anatomic and biomechanical variations originating in the pelvic region might be related to the complaint of sciatica. The criteria for diagnosis are based on findings from both physical examination and radio imaging. Piriformis syndrome resembles a variety of clinical conditions; therefore, conduct of future studies should include development of a validated method for evaluation as well as clinical criteria for diagnosis of piriformis syndrome.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/6b/hp-35-1.PMC10020728.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9515018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Hip Microinstability with Arthroscopic Capsular Plication: A Retrospective Case Series.","authors":"Tatiana Charles,&nbsp;Marc Jayankura,&nbsp;Frédéric Laude","doi":"10.5371/hp.2023.35.1.15","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.15","url":null,"abstract":"<p><strong>Purpose: </strong>Hip microinstability is defined as hip pain with a snapping and/or blocking sensation accompanied by fine anatomical anomalies. Arthroscopic capsular plication has been proposed as a treatment modality for patients without major anatomic anomalies and after failure of properly administered conservative treatment. The purpose of this study was to determine the efficacy of this procedure and to evaluate potential predictors of poor outcome.</p><p><strong>Materials and methods: </strong>A review of 26 capsular plications in 25 patients was conducted. The mean postoperative follow-up period for the remaining patients was 29 months. Analysis of data included demographic, radiological, and interventional data. Calculation of pre- and postoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index was performed. Pre- and postoperative sports activities and satisfaction were also documented. A <i>P</i><0.05 was considered significant.</p><p><strong>Results: </strong>No major complications were identified in this series. The mean pre- and postoperative WOMAC scores were 62.6 and 24.2, respectively. The WOMAC index showed statistically significant postoperative improvement (<i>P</i>=0.0009). The mean satisfaction rate was 7.7/10. Four patients with persistent pain underwent a periacetabular osteotomy. A lateral center edge angle ≤21° was detected in all hips at presentation. We were not able to demonstrate any difference in postoperative evolution with regard to the presence of hip dysplasia (<i>P</i>>0.05), probably because the sample size was too small.</p><p><strong>Conclusion: </strong>Capsular plication can result in significant clinical and functional improvement in carefully selected cases of hip microinstability.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/89/hp-35-15.PMC10020731.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study for Osteosynthesis of Femoral Neck Fractures: Cannulated Screws versus Femoral Neck System.","authors":"Youngho Cho,&nbsp;Jae-Uk Shin,&nbsp;Sangwoo Kim","doi":"10.5371/hp.2023.35.1.47","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.47","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures.</p><p><strong>Materials and methods: </strong>A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated.</p><p><strong>Results: </strong>The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation.</p><p><strong>Conclusion: </strong>A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/77/hp-35-47.PMC10020727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Outcome after Reimplantation in Patients Treated with and without an Antibiotic-Loaded Cement Spacers for Hip Prosthetic Joint Infections.","authors":"Michele Fiore,&nbsp;Claudia Rondinella,&nbsp;Azzurra Paolucci,&nbsp;Lorenzo Morante,&nbsp;Massimiliano De Paolis,&nbsp;Andrea Sambri","doi":"10.5371/hp.2023.35.1.32","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.32","url":null,"abstract":"<p><strong>Purpose: </strong>A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the \"gold standard\" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur. The aim of this study is to evaluate functional results and infection control in two-stage treatment of total hip arthroplasty (THA) PJI with and without a spacer.</p><p><strong>Materials and methods: </strong>A retrospective review of 64 consecutive patients was conducted: 34 underwent two-stage revision using a cement spacer (group A), 30 underwent two-stage revision without a spacer (group B). At the final follow-up, functional evaluation of patients with a THA in site, without PJI recurrence, was performed using the Harris hip score (HHS). Measurement of limb-length and off-set discrepancies was performed using anteroposterior pelvic X-rays.</p><p><strong>Results: </strong>Most patients in group B were older with more comorbidities preoperatively. Thirty-three patients (97.1%) in group A underwent THA reimplantation versus 22 patients (73.3%) in group B (<i>P</i><0.001). No significant differences in limb-length and off-set were observed. The results of functional evaluation performed during the final follow-up (mean, 41 months) showed better function in patients in group A (mean HHS, 76.3 vs. 55.9; <i>P</i><0.001).</p><p><strong>Conclusion: </strong>The use of antibiotic-loaded cement spacer seems superior in terms of functional outcomes and reimplantation rate. Resection arthroplasty might be reserved as a first-stage procedure in patients who are unfit, who might benefit from a definitive procedure.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/73/hp-35-32.PMC10020733.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9515013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Hip Arthroplasty with Cemented Dual Mobility Cup into a Fully Porous Multihole Cup with Variable Angle Locking Screws for Acetabular Fractures in the Frail Elderly.","authors":"Mathias van den Broek,&nbsp;Kris Govaers","doi":"10.5371/hp.2023.35.1.54","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.54","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose was to examine the clinical and radiological outcomes after surgical treatment of acetabular fractures with total hip arthroplasty with a dual mobility cup cemented into a porous multihole cup in the population of frail elderly patients.</p><p><strong>Materials and methods: </strong>A retrospective review of 16 patients who underwent surgery (mean age, 76.7 years) with a mean follow-up period of 36.9 months was conducted. Following surgery, patients underwent postoperative follow-up at six weeks, three, six, and 12 months and clinical and radiological examinations were performed.</p><p><strong>Results: </strong>Classification of fractures was based on the Letournel classification. Following surgery, all patients were allowed weight-bearing as tolerated immediately postoperative. Fourteen patients showed maintenance of preoperative mobility status at one year. The mean Harris hip score was 64.8 (range, 34.7-82.8) and 80.0 (range, 60.8-93.8) at three months and one year, respectively. The mortality rate was 12.5% at one year (2/16). Complications included heterotopic ossification (2/16), deep venous thrombosis (1/16), heamatoma (1/16), and femoral revision due to a Vancouver B2 fracture (1/16). No case of deep infection, dislocation, or implant loosening was reported.</p><p><strong>Conclusion: </strong>Total hip arthroplasty using a dual mobility cup cemented into a porous multihole cup with locking screws resulted in a stable construct with a capacity for immediate weight-bearing as tolerated with rapid relief of pain. The findings of this study suggest that this procedure can be regarded as a safe method that has shown promising clinical and radiological outcomes for treatment of patients with medical frailty.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/d2/hp-35-54.PMC10020729.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9146891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?","authors":"Nemandra Amir Sandiford,&nbsp;Scott M Bolam,&nbsp;Irrum Afzal,&nbsp;Sarkhell Radha","doi":"10.5371/hp.2023.35.1.40","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.40","url":null,"abstract":"<p><strong>Purpose: </strong>A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA.</p><p><strong>Materials and methods: </strong>This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years.</p><p><strong>Results: </strong>In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups.</p><p><strong>Conclusion: </strong>Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"40-46"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/e4/hp-35-40.PMC10020730.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Excision for Refractory Ischiogluteal Bursitis: A Consecutive Case Series of 21 Patients.","authors":"Sun-Ho Lee,&nbsp;Won-Young Jang,&nbsp;Min-Su Lee,&nbsp;Taek-Rim Yoon,&nbsp;Kyung-Soon Park","doi":"10.5371/hp.2023.35.1.24","DOIUrl":"https://doi.org/10.5371/hp.2023.35.1.24","url":null,"abstract":"<p><strong>Purpose: </strong>A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome.</p><p><strong>Materials and methods: </strong>A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed.</p><p><strong>Results: </strong>The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively.</p><p><strong>Conclusion: </strong>Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"35 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/a3/hp-35-24.PMC10020732.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning from the Posterior Approach to the Direct Anterior Approach for Total Hip Arthroplasty.","authors":"Cameron M Metzger,&nbsp;Hassan Farooq,&nbsp;Jacqueline O Hur,&nbsp;John Hur","doi":"10.5371/hp.2022.34.4.203","DOIUrl":"https://doi.org/10.5371/hp.2022.34.4.203","url":null,"abstract":"<p><strong>Purpose: </strong>Total hip arthroplasty (THA) using the direct anterior approach (DAA) is known to have a learning curve. The purpose of this study was to review cases where surgery was performed by an arthroplasty surgeon transitioning from the posterior approach (PA) to the DAA. We hypothesized similar complication rates and improvements in surgical duration over time.</p><p><strong>Materials and methods: </strong>A review of 2,452 consecutive primary THAs was conducted. Surgical duration, length of stay (LOS), surgical complications, decrease in postoperative day (POD) 1 hemoglobin, transfusion rates, POD 0 and POD 1 pain scores, incision length, leg length discrepancy (LLD), and radiographic cup position were recorded.</p><p><strong>Results: </strong>No differences in surgical duration were observed after the first 50 DAA cases. A shorter LOS was observed for the DAA, and statistical difference was appreciated after the first 100 DAA cases. There were no differences in periprosthetic fractures. A higher rate of infections and hip dislocations were observed with the PA. The PA showed an association with higher transfusion rates without significant difference in POD 1 decrease in hemoglobin over the first 100 DAA cases. Similar POD 0 and POD 1 pain scores with a smaller incision were observed for the first 100 DAA cases. The DAA cohort showed less variation in cup inclination, version, and LLD.</p><p><strong>Conclusion: </strong>DAA is safe and non-inferior in terms of reduced LOS, smaller incision, and less variation in cup position. Fifty DAA cases was noted to be the learning curve required before no differences in duration between approaches were observed.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"34 4","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/d6/hp-34-203.PMC9763831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10840173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}