Earlier functional recovery and discharge from hospital for THA patients operated on via direct superior compared to standard posterior approach: a retrospective frequency-matched case-control study,Hip International

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Earlier functional recovery and discharge from hospital for THA patients operated on via direct superior compared to standard posterior approach: a retrospective frequency-matched case-control study
Hip International ( IF 1.3 ) Pub Date : 2022-04-19 , DOI: 10.1177/11207000221086506
Eustathios Kenanidis _{1,

2} , George Paparoidamis _{1,

2} , Vasileios F Pegios _{1,

2} , Panagiotis Anagnostis _{1,

2} , Michael Potoupnis _{1,

2} , Eleftherios Tsiridis _{1,

2}

Affiliation

Background:

The direct superior hip approach (DSA) has been less researched than other approaches in the literature. We retrospectively compared the early postoperative and functional outcomes of patients with hip osteoarthritis undergoing total hip arthroplasty (THA) via DSA with a matched control group using a standard posterior approach (SPA).

Methods:

The DSA group comprised 100 THAs performed via DSA by a senior surgeon between January 2018 and May 2019. Patients with primary osteoarthritis and ASA score ⩽3 who were eligible for surgery were included. The DSA group was compared to a matched cohort of 100 patients operated on with a SPA in the same period by another chief surgeon. Patients were matched for age, sex, and ASA score. All patients received the same postoperative chemoprophylaxis, pain management and physiotherapy. 2 independent attending arthroplasty surgeons assessed the incision length, operative time, blood loss, hospital stay, and complications. VAS, HHS, and HOOS scores were also evaluated for a year postoperatively.

Results:

Mean incision length and hospital stay were significantly lower in the DSA group. DSA patients had non-significantly lower intraoperative blood loss, transfusion needs, and postoperative pain than SPA patients. Mean operation time and complication rate did not differ between groups. The DSA group demonstrated significantly greater functional scores than the SPA group at the first postoperative month. No differences in scores were recorded following the third month.

Conclusions:

The DSA approach may provide earlier functional recovery and hospital discharge for THA patients compared with SPA. DSA was equivalent to SPA concerning pain and blood loss, showing minimal complication rates.

中文翻译：

与标准后路手术相比，通过直接优越手术的 THA 患者早期功能恢复和出院：一项回顾性频率匹配病例对照研究

背景：

与文献中的其他方法相比，直接上髋入路 (DSA) 的研究较少。我们回顾性比较了通过 DSA 接受全髋关节置换术 (THA) 的髋骨关节炎患者与使用标准后路入路 (SPA) 的匹配对照组的早期术后和功能结果。

方法：

DSA 组包括 2018 年 1 月至 2019 年 5 月期间由一名高级外科医生通过 DSA 进行的 100 例 THA。包括符合手术条件的原发性骨关节炎和 ASA 评分 3 的患者。DSA 组与同一时期由另一位首席外科医生进行 SPA 手术的 100 名患者的匹配队列进行了比较。患者的年龄、性别和 ASA 评分相匹配。所有患者都接受了相同的术后化学预防、疼痛管理和物理治疗。2 名独立的关节成形术外科医生评估了切口长度、手术时间、失血量、住院时间和并发症。术后一年也评估了 VAS、HHS 和 HOOS 评分。