Retrospective Analysid Of Outcomes After Different Surgical Approaches For Tha
Keywords:
Total Hip Arthroplasty, Posterior Approach, Direct Anterior Approach, Lateral Approach, Surgical Outcomes, Functional Recovery, Pain Scores, Harris Hip Score, Dislocation, Orthopedic SurgeryAbstract
Background: Total Hip Arthroplasty (THA) is a widely performed orthopedic procedure aimed at alleviating pain and restoring mobility in patients with hip joint disorders such as osteoarthritis, rheumatoid arthritis, and avascular necrosis. Among the various surgical approaches, the posterior, direct anterior, and lateral techniques are most commonly employed. Each approach presents unique benefits and limitations in terms of surgical access, complication rates, functional recovery, and postoperative rehabilitation. This study aims to compare the outcomes associated with these three approaches in a single-center, retrospective setting.
Methods: A retrospective observational study was conducted from March 2023 to September 2024, including 50 patients who underwent primary THA. Patients were grouped based on the surgical approach used: posterior (n = 20), direct anterior (n = 15), and lateral (n = 15). Data collected included demographic details, operative time, blood loss, pain scores (VAS), functional outcome (Harris Hip Score at 6 months), complication rates, and length of hospital stay. Statistical analysis was performed using SPSS software, with a p-value < 0.05 considered significant.
Results: The direct anterior approach demonstrated the most favorable outcomes, with the lowest VAS pain scores (1.8), highest Harris Hip Scores (91.5), and shortest hospital stay (3.8 days). The posterior approach had the shortest operative time (76 minutes) but was associated with two cases of dislocation. The lateral approach yielded intermediate outcomes, with no dislocations reported. One case of temporary nerve symptoms was noted in the anterior group.
Conclusion: While all three approaches significantly improved pain and function, the direct anterior approach offered superior early outcomes. However, surgical approach selection should be individualized based on patient anatomy, comorbidities, and surgeon experience. Further prospective studies are needed to confirm these findings.
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References
Pincus, D., Jenkinson, R., Paterson, M., Leroux, T., & Ravi, B. (2020). Association between surgical approach and major surgical complications in patients undergoing total hip arthroplasty. Jama, 323(11), 1070-1076.
Yoo, S., Lee, H. B., Han, W., Noh, D. Y., Park, S. K., Kim, W. H., & Kim, J. T. (2019). Total intravenous anesthesia versus inhalation anesthesia for breast cancer surgery: a retrospective cohort study. Anesthesiology, 130(1), 31-40.
Ljungberg, B., Albiges, L., Abu-Ghanem, Y., Bedke, J., Capitanio, U., Dabestani, S., ... & Bex, A. (2022). European Association of Urology guidelines on renal cell carcinoma: the 2022 update. European urology, 82(4), 399-410.
Batchelor, T. J., Rasburn, N. J., Abdelnour-Berchtold, E., Brunelli, A., Cerfolio, R. J., Gonzalez, M., ... & Naidu, B. (2019). Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). European journal of cardio-thoracic surgery, 55(1), 91-115.
McCann, M. E., & Soriano, S. G. (2019). Does general anesthesia affect neurodevelopment in infants and children?. Bmj, 367.
Farag, M., Timm, B., Davis, N., Wong, L. M., Bolton, D. M., & Jack, G. S. (2020). Pressurized-bag irrigation versus hand-operated irrigation pumps during ureteroscopic laser lithotripsy: comparison of infectious complications. Journal of endourology, 34(9), 914-918.
Guaraldi, G., Meschiari, M., Cozzi-Lepri, A., Milic, J., Tonelli, R., Menozzi, M., ... & Mussini, C. (2020). Tocilizumab in patients with severe COVID-19: a retrospective cohort study. The Lancet Rheumatology, 2(8), e474-e484.
Di Saverio, S., Podda, M., De Simone, B., Ceresoli, M., Augustin, G., Gori, A., ... & Catena, F. (2020). Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World journal of emergency surgery, 15, 1-42.
Ran, L., Chen, X., Wang, Y., Wu, W., Zhang, L., & Tan, X. (2020). Risk factors of healthcare workers with coronavirus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China. Clinical infectious diseases, 71(16), 2218-2221.
Yu, N., Li, W., Kang, Q., Xiong, Z., Wang, S., Lin, X., ... & Wu, J. (2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. The Lancet Infectious Diseases, 20(5), 559-564.
Lebas, A., Le Fevre, C., Waissi, W., Chambrelant, I., Brinkert, D., & Noel, G. (2024). Factors influencing long-term local recurrence, distant metastasis, and survival in patients with soft tissue sarcoma of the extremities treated with radiotherapy. Cancers, 16(10), 1789.
Ljungberg, B., Albiges, L., Abu-Ghanem, Y., Bensalah, K., Dabestani, S., Fernández-Pello, S., ... & Bex, A. (2019). European association of urology guidelines on renal cell carcinoma: the 2019 update. European urology, 75(5), 799-810.
Senev, A., Coemans, M., Lerut, E., Van Sandt, V., Kerkhofs, J., Daniëls, L., ... & Naesens, M. (2020). Eplet mismatch load and de novo occurrence of donor-specific anti-HLA antibodies, rejection, and graft failure after kidney transplantation: an observational cohort study. Journal of the American Society of Nephrology, 31(9), 2193-2204.
Dell-Kuster, S., Gomes, N. V., Gawria, L., Aghlmandi, S., Aduse-Poku, M., Bissett, I., ... & Rosenthal, R. (2020). Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study. bmj, 370.
Quénet, F., Elias, D., Roca, L., Goéré, D., Ghouti, L., Pocard, M., ... & RAT, P. (2021). Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial. The Lancet Oncology, 22(2), 256-266.
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