{"title":"直接前路与后路全髋关节置换术的功能效果:一项倾向匹配的亚洲研究。","authors":"Bryan Loh, Akshay Padki, Andy Yew, Hee Nee Pang","doi":"10.4103/singaporemedj.SMJ-2021-125","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected registry data of 794 primary THAs was performed. The effects on patients with DAA THA versus patients with PA THA were investigated. Propensity scores were generated using logistic regression to adjust for confounding variables of age, gender, body mass index and diagnosis. Data analysis was performed, and statistical significance was defined as a P value < 0.05.</p><p><strong>Results: </strong>The average length of stay (LOS) for the PA group and DAA group was 5.4 days and 2.9 days, respectively (P < 0.001). One (1.9%) patient from the PA group suffered a posterior dislocation 6 months after surgery and subsequently underwent revision surgery 2 years later. No dislocations were detected in the DAA group. The DAA group had better functional outcome, satisfaction and expectation scores at 6 months and 2 years.</p><p><strong>Conclusion: </strong>In this study, patients who underwent DAA THA had better functional outcome at 2 years and almost 2 days shorter overall LOS than those who underwent PA THA. Therefore, the DAA to THA is a novel technique that has shown improved functional outcomes, with fewer complications compared to PA THA.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Functional outcome of direct anterior versus posterior approach in total hip arthroplasty: a propensity-matched Asian study.\",\"authors\":\"Bryan Loh, Akshay Padki, Andy Yew, Hee Nee Pang\",\"doi\":\"10.4103/singaporemedj.SMJ-2021-125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected registry data of 794 primary THAs was performed. The effects on patients with DAA THA versus patients with PA THA were investigated. Propensity scores were generated using logistic regression to adjust for confounding variables of age, gender, body mass index and diagnosis. Data analysis was performed, and statistical significance was defined as a P value < 0.05.</p><p><strong>Results: </strong>The average length of stay (LOS) for the PA group and DAA group was 5.4 days and 2.9 days, respectively (P < 0.001). One (1.9%) patient from the PA group suffered a posterior dislocation 6 months after surgery and subsequently underwent revision surgery 2 years later. No dislocations were detected in the DAA group. The DAA group had better functional outcome, satisfaction and expectation scores at 6 months and 2 years.</p><p><strong>Conclusion: </strong>In this study, patients who underwent DAA THA had better functional outcome at 2 years and almost 2 days shorter overall LOS than those who underwent PA THA. Therefore, the DAA to THA is a novel technique that has shown improved functional outcomes, with fewer complications compared to PA THA.</p>\",\"PeriodicalId\":94289,\"journal\":{\"name\":\"Singapore medical journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Singapore medical journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/singaporemedj.SMJ-2021-125\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Singapore medical journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/singaporemedj.SMJ-2021-125","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
简介:直接前路(DAA)全髋关节置换术(THA)是一种最大限度减少软组织创伤的手术方法,与后路(PA)相比,其康复速度更快。本研究旨在利用倾向得分匹配法评估亚洲队列中两组患者的差异:方法:对前瞻性收集的 794 例初次 THAs 登记数据进行了回顾性分析。研究调查了DAA THA患者与PA THA患者的对比效果。使用逻辑回归生成倾向评分,以调整年龄、性别、体重指数和诊断等混杂变量。对数据进行了分析,P 值小于 0.05 即为统计学意义:PA 组和 DAA 组的平均住院时间(LOS)分别为 5.4 天和 2.9 天(P < 0.001)。PA组有一名(1.9%)患者在术后6个月出现后脱位,2年后接受了翻修手术。DAA组未发现脱位。DAA组患者在6个月和2年后的功能结果、满意度和期望值评分均优于PA组:在这项研究中,与接受 PA THA 的患者相比,接受 DAA THA 的患者 2 年后的功能预后更好,总的 LOS 缩短了近 2 天。因此,与 PA THA 相比,DAA to THA 是一种新型技术,可改善功能预后,减少并发症。
Functional outcome of direct anterior versus posterior approach in total hip arthroplasty: a propensity-matched Asian study.
Introduction: The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching.
Methods: A retrospective review of prospectively collected registry data of 794 primary THAs was performed. The effects on patients with DAA THA versus patients with PA THA were investigated. Propensity scores were generated using logistic regression to adjust for confounding variables of age, gender, body mass index and diagnosis. Data analysis was performed, and statistical significance was defined as a P value < 0.05.
Results: The average length of stay (LOS) for the PA group and DAA group was 5.4 days and 2.9 days, respectively (P < 0.001). One (1.9%) patient from the PA group suffered a posterior dislocation 6 months after surgery and subsequently underwent revision surgery 2 years later. No dislocations were detected in the DAA group. The DAA group had better functional outcome, satisfaction and expectation scores at 6 months and 2 years.
Conclusion: In this study, patients who underwent DAA THA had better functional outcome at 2 years and almost 2 days shorter overall LOS than those who underwent PA THA. Therefore, the DAA to THA is a novel technique that has shown improved functional outcomes, with fewer complications compared to PA THA.