Tae-Gyu Park, Young-Yool Chung, Young-Jae Kim, Min-Seok Kim
{"title":"75岁及以上老年人全髋关节置换术直接前路与后外侧入路的比较。","authors":"Tae-Gyu Park, Young-Yool Chung, Young-Jae Kim, Min-Seok Kim","doi":"10.5371/hp.2025.37.3.205","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The study investigated the benefits of the direct anterior approach (DAA) compared to the posterolateral approach (PLA) in patients over 75 years of age.</p><p><strong>Materials and methods: </strong>This study included 144 patients who underwent total hip arthroplasty (THA) from December 2012 to November 2021. Group A had 93 patients with a mean age of 80.8±5.0 years, who underwent DAA. Group B had 51 patients with a mean age of 79.7±4.6 years, who underwent PLA. Clinical outcomes included operative time, time to ambulation, walking ability, and complications.</p><p><strong>Results: </strong>There were no demographic differences between the groups. The mean age was 80.9±5.0 years in Group A and 80.5±4.8 years in Group B. Mean operative time was 94.2±7.2 minutes in Group A and 91.2±8.8 minutes in Group B (<i>P</i>=0.02). Early ambulation within 3 days postoperatively was seen in 72 patients (77.4%) in Group A and 31 patients (60.8%) in Group B (<i>P</i>=0.03). No significant change was seen in modified Koval Index in Group A (4.35 to 4.06, <i>P</i>=0.51), while Group B showed a significant decrease (4.47 to 3.88, <i>P</i>=0.04). The postoperative modified Koval index negatively correlated with time to ambulation (<i>P</i>=-0.17, <i>P</i>=0.04). Dislocation occurred in 3 patients (3.2%) in Group A and 7 patients (13.7%) in Group B (<i>P</i>=0.02). No differences were found in medical complications or mortality.</p><p><strong>Conclusion: </strong>THA via DAA may provide earlier functional recovery than PLA, with comparable safety in patients over 75 years of age.</p>","PeriodicalId":73239,"journal":{"name":"Hip & pelvis","volume":"37 3","pages":"205-212"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417865/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of Direct Anterior Approach and Posterolateral Approach in Total Hip Arthroplasty in Elderly People Aged 75 Years or Older.\",\"authors\":\"Tae-Gyu Park, Young-Yool Chung, Young-Jae Kim, Min-Seok Kim\",\"doi\":\"10.5371/hp.2025.37.3.205\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The study investigated the benefits of the direct anterior approach (DAA) compared to the posterolateral approach (PLA) in patients over 75 years of age.</p><p><strong>Materials and methods: </strong>This study included 144 patients who underwent total hip arthroplasty (THA) from December 2012 to November 2021. Group A had 93 patients with a mean age of 80.8±5.0 years, who underwent DAA. Group B had 51 patients with a mean age of 79.7±4.6 years, who underwent PLA. Clinical outcomes included operative time, time to ambulation, walking ability, and complications.</p><p><strong>Results: </strong>There were no demographic differences between the groups. The mean age was 80.9±5.0 years in Group A and 80.5±4.8 years in Group B. Mean operative time was 94.2±7.2 minutes in Group A and 91.2±8.8 minutes in Group B (<i>P</i>=0.02). Early ambulation within 3 days postoperatively was seen in 72 patients (77.4%) in Group A and 31 patients (60.8%) in Group B (<i>P</i>=0.03). No significant change was seen in modified Koval Index in Group A (4.35 to 4.06, <i>P</i>=0.51), while Group B showed a significant decrease (4.47 to 3.88, <i>P</i>=0.04). The postoperative modified Koval index negatively correlated with time to ambulation (<i>P</i>=-0.17, <i>P</i>=0.04). Dislocation occurred in 3 patients (3.2%) in Group A and 7 patients (13.7%) in Group B (<i>P</i>=0.02). No differences were found in medical complications or mortality.</p><p><strong>Conclusion: </strong>THA via DAA may provide earlier functional recovery than PLA, with comparable safety in patients over 75 years of age.</p>\",\"PeriodicalId\":73239,\"journal\":{\"name\":\"Hip & pelvis\",\"volume\":\"37 3\",\"pages\":\"205-212\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417865/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hip & pelvis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5371/hp.2025.37.3.205\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hip & pelvis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5371/hp.2025.37.3.205","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparison of Direct Anterior Approach and Posterolateral Approach in Total Hip Arthroplasty in Elderly People Aged 75 Years or Older.
Purpose: The study investigated the benefits of the direct anterior approach (DAA) compared to the posterolateral approach (PLA) in patients over 75 years of age.
Materials and methods: This study included 144 patients who underwent total hip arthroplasty (THA) from December 2012 to November 2021. Group A had 93 patients with a mean age of 80.8±5.0 years, who underwent DAA. Group B had 51 patients with a mean age of 79.7±4.6 years, who underwent PLA. Clinical outcomes included operative time, time to ambulation, walking ability, and complications.
Results: There were no demographic differences between the groups. The mean age was 80.9±5.0 years in Group A and 80.5±4.8 years in Group B. Mean operative time was 94.2±7.2 minutes in Group A and 91.2±8.8 minutes in Group B (P=0.02). Early ambulation within 3 days postoperatively was seen in 72 patients (77.4%) in Group A and 31 patients (60.8%) in Group B (P=0.03). No significant change was seen in modified Koval Index in Group A (4.35 to 4.06, P=0.51), while Group B showed a significant decrease (4.47 to 3.88, P=0.04). The postoperative modified Koval index negatively correlated with time to ambulation (P=-0.17, P=0.04). Dislocation occurred in 3 patients (3.2%) in Group A and 7 patients (13.7%) in Group B (P=0.02). No differences were found in medical complications or mortality.
Conclusion: THA via DAA may provide earlier functional recovery than PLA, with comparable safety in patients over 75 years of age.
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