Accuracy of the modified Hardinge approach in acetabular positioning

Goyal, Prateek; Lau, Adrian Cheng Kiang; McCalden, Richard W.; Teeter, Matthew G.; Howard, James L.; Lanting, Brent A.

doi:10.1503/cjs.011415

Cited by 10 publications

(4 citation statements)

References 36 publications

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“…Masonis reported that the lowest rate of dislocation after THA occurred with the direct lateral approach (0.55%) compared with the transtrochanteric approach (1.27%), P‐L approach (3.23%), and anterolateral approach (2.18%) 27 . Moreover, Goyal found only one case of dislocation in 1010 patients (0.09%) who underwent THA using the modified Hardinge approach 28 . In our study, we used the modified Hardinge approach and obtained satisfactory results regarding dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…Classic Safe Zone and Combined Anteversion May Not Be Suitable for THA Using the Lateral Approach Interestingly, many studies have noted that THAs using the lateral approach may lead to a lower rate of implants being positioned properly in the Lewinnek safe zone than THAs using the P-L approach, but THAs using the lateral approach lead to fewer dislocations 5,28 . We also found that only 52.9% of patients had measurements within the Lewinnek safe zone.…”

Section: Different Approaches Exhibit Distinct Implant Orientationsmentioning

confidence: 99%

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A Specific Anteversion of Cup and Combined Anteversion for Total Hip Arthroplasty Using Lateral Approach

Zhang

Lin

et al. 2020

Orthopaedic Surgery

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Objective To determine the implant orientation, especially the combined anteversion measurements in total hip arthroplasty (THA) using lateral approach, and to compare with implant orientation using posterior‐lateral (P‐L) approach. The secondary goal was to identify the factors associated with implant orientation. Methods Five hundred and one patients (545 hips) who underwent primary THA with the modified Hardinge approach between January 2016 and November 2019 by one senior surgeon in our department in a retrospective study were followed up. A survey to inquire about the history of dislocation of the hip after THA was designed and responses were gathered by telephone, WeChat software, and outpatient follow‐up. The mean age of the patients was 61.97 ± 11.72 years, and there were 254 males and 247 females. The average follow‐up time was 25.2 ± 13.7 months (range, 3.2–49.7 months). Among the patients who were followed up, 97 patients (104 hips) underwent computed tomography (CT) scans from L4 to the tuberosity of the tibia. The implant orientation, including the anteversion and inclination of the cup, anteversion of the stem, combined anteversion, and pelvic tilt were measured based on CT scans of these patients. The results were compared with the implant orientation reported in previous reports measured by CT. Factors that may be associated with implant orientation were investigated, including the patient's age, sex, body mass index (BMI), and diagnosis; size of the cup; diameter of the femoral head component; and pelvic tilt. Data and statistical analyses were performed using SPSS 20.0. Results No cases of dislocation were found in the 501 patients (545 hips) who underwent primary THA during this period. The mean inclination and anteversion of the cups were 38.83° ± 5.04° (24.5°–53.1°) and 9.26° ± 11.19° (−15°–48°), respectively. The mean anteversion of the stem was 13.83° ± 10.7° (−10.2°–42.3°). The combined anteversion was 23.1° ± 13.4° (−7.4°–54.6°). Compared with the reported combined anteversion and anteversion of the cup, the mean anteversion of the cup and combined anteversion using the lateral approach were much lower than the reported values in the literature using the P‐L approach. Pelvic tilt was found to be the only independent factor for cup anteversion. Factors including age, sex, BMI, diagnosis, cup size, and diameter of the femoral head component were not associated with implant orientation. Conclusion THA using the lateral approach yields smaller cup anteversion and combined anteversion values than using the P‐L approach. Pelvic tilt is the only predictor for cup anteversion.

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Section: Discussionmentioning

confidence: 99%

Section: Different Approaches Exhibit Distinct Implant Orientationsmentioning

confidence: 99%

A Specific Anteversion of Cup and Combined Anteversion for Total Hip Arthroplasty Using Lateral Approach

Zhang

Lin

et al. 2020

Orthopaedic Surgery

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“…This method involved removing the gluteus medius tendon from its attachment off the trochanter and conducting a subperiosteal dissection from the trochanter continuous with the vastus lateralis tendon [ 29 , 38 ]. The most well-known LA was described by Hardinge and involved splitting the gluteus medius and minimus tendons longitudinally and continuing distally into the vastus lateralis tendon [ 39 ]. Soon after, the anterolateral approach gained popularity and was well developed by Sir Watson-Jones.…”

Section: Approaches In Total Hip Arthroplastymentioning

confidence: 99%

Surgical Approaches in Total Hip Arthroplasty

Supra¹,

Supra²,

Agrawal³

2023

J Ortho Sports Med

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The Total Hip Arthroplasty (THA) has become one of the most reliable surgical interventions that has improved the quality of life in many patients. THA allows patients to have increased mobility, range of motion, and reduced pain in patients with degenerative hip joints. This surgical procedure has become an effective treatment option for several chronic conditions affecting the hip joint. Although this surgery has been shown to give promising results in patients with hip pathology, selecting the approach for THA is a critical step in pre-operative planning. The best approach for this surgical procedure depends on multiple factors and each present with their own challenges, success rates, and limitations. To further elucidate the advantages and disadvantages associated with different surgical approaches, we critically review each surgical approach along with the different causes of failure of the THA procedure.

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“…THA, one of the greatest advances in orthopedic surgery, can signi cantly improve the quality of life of patients with end-stage hip joint disease, increase function, restore range of joint movement, and relieve pain [9,10]. There are multiple surgical approaches for THA, including traditional posterior approach (PA), anterior approach (AA), lateral approach (LA) and modi ed Hardinge approach [11,12]. These traditional surgical approaches have some common shortcomings of external trochanter muscle injury, postoperative dislocation and longer recovery time [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Comparison The Early Clinical Efficacy of SuperPath Approach Versus The Modified Hardinge Approach In Total Hip Arthroplasty For Femoral Neck Fractures In Elderly: A Randomized Controlled Trial

Shen

et al. 2021

Preprint

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Purpose: Femoral neck fracture is a common form of hip fracture in the elderly. Minimally invasive surgery is very popular in recent years. This study was to investigate the clinical efficacy and advantages of the SuperPath approach to total hip arthroplasty in the treatment of femoral neck fractures in the elderly. Methods: From February 2018 to March 2019, 120 patients were random divided into two groups with 60 patients each: the SuperPath group and conventional group. The results evaluated the general operation situation, Serum markers, blood loss, pain score, hip function and prosthesis location analysis.Results: There was no difference demographically between two groups. Compared with the conventional group, the SuperPath group had a shorter operation time (78.4 vs 93.0 min), smaller incision length (5.8 vs 12.5 cm), less intraoperative blood loss (121.5 vs 178.8 ml), shorter hospitalization time (8.0 vs 10.8 day) and less drainage volume (77.8 vs 141.2 ml). The creatine kinase (CK) in the SuperPath group was significantly lower, while there was no difference in the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The visual analog scale (VAS) was lower in one month and Harris Hip Score (HHS) were higher in three months in the SuperPath group. There was no difference in the cup abduction angle and anteversion angle of the two groups.Conclusion: We found the better clinical efficacy after the SuperPath approach with less muscle damage, less postoperative pain and better postoperative function compared with the modified Hardinge approach.Trial registration: Retrospectively registered. The randomized clinical trial was retrospective registered at Chinese Clinical Trial Registry on December 31, 2020 (ChiCTR-2000041583, http://www.chictr.org.cn/showproj.aspx?proj=57008).

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Accuracy of the modified Hardinge approach in acetabular positioning

Cited by 10 publications

References 36 publications

A Specific Anteversion of Cup and Combined Anteversion for Total Hip Arthroplasty Using Lateral Approach

A Specific Anteversion of Cup and Combined Anteversion for Total Hip Arthroplasty Using Lateral Approach

Surgical Approaches in Total Hip Arthroplasty

Comparison The Early Clinical Efficacy of SuperPath Approach Versus The Modified Hardinge Approach In Total Hip Arthroplasty For Femoral Neck Fractures In Elderly: A Randomized Controlled Trial

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