Comparative prospective randomized study of minimally invasive transpiriformis approach versus conventional posterolateral approach in total hip arthroplasty as measured by biology markers

Xiao, Cong; Gao, Zhixiang; Zhang, Shaoyun; Long, Nengji; Yao, Kai; Cai, Peng; He, Fenglai; Liu, Lijuan; Jiang, Yishan

doi:10.1007/s00264-021-05083-5

Cited by 8 publications

(23 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We determined the serum levels of IL-6, CRP, and CK between patients 24 h after extra-articular distal humeral APLCP through posterior approaches and LPO. IL-6, CRP, and CK are three biology markers and their reductions were used to reflect less muscle damage caused by invasive orthopaedic surgery [ 20 ]. It was found that although the serum levels of IL-6, CRP, and CK were elevated 24 h after surgery, the patients receiving implantation of APLCPs through a posterior approach exhibited lower serum levels of IL-6, CRP, and CK compared to LPO, suggesting extra-articular distal humeral APLCP through posterior approaches leads to attenuated inflammatory response, preventing patients from soft tissue injury.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome and Inflammatory Response of Patients with Extra-Articular Distal Humeral Fractures following Implantation of Anatomically Precontoured Locking Compression Plates through a Posterior Approach

Liu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Distal humeral fractures are challenging injuries to surgically correct and account for up to 2% of all adult fractures. Surgical management of extra-articular distal humeral fractures is challenging considering surgical approach, implant selection, and position of the implant owing to the availability of different precontoured implants and plate configurations. Anatomically precontoured locking compression plates (APLCPs) allow the placement of angular stable screws right underneath the reduced joint surface fragments. To date, there is a lack of evidence supporting its superiority to conventional locking plate osteosynthesis (LPO) in treating extra-articular distal humeral fractures. The objective of the study is to evaluate the efficacy and safety of APLCPs in the treatment of extra-articular distal humeral fractures. A total of 100 patients diagnosed with humeral fractures and receiving treatments in our hospital between May 2018 and May 2020 fulfilled inclusion and exclusion criteria and were randomly assigned to LPO and APLCP groups according to the odd-even of the order of hospital admission, 50 cases per groups. Clinical endpoints were assessed including operation time; in-bed time; length of hospital stay; volume of intraoperative blood loss; VSA scores before and 24, 48, and 72 h after surgery; MEPS scores before and 3, 6, and 12 months after surgery; range of motion, flexion, and extension of the elbow; serum levels of CK, CRP, and IL-6; and incidence of complications after surgery. It was found that the APLCP group exhibited shortened operation time and in-bed time, decreased length of hospital stay, and reduced volume of intraoperative blood loss compared to the LPO group (all P < 0.001 ). The two groups had declined VSA scores concomitant with increased MEPS scores after surgery in a time-dependent manner ( P < 0.001 ). Notably, the VSA scores in the APLCP group were all lower than those in the LPO group at indicated time points (24, 48, and 72 h) after surgery ( P < 0.001 ). Besides, the MEPS scores in the APLCP group were all higher than those in the LPO group at indicated time points (3, 6, and 12 months) after surgery ( P < 0.001 ). It was revealed that the patients receiving extra-articular distal humeral APLCP through posterior approaches exhibited greater ranges of motion, flexion, and extension of the elbow than those receiving LPO after surgery ( P < 0.001 ). The patients receiving extra-articular distal humeral APLCP through posterior approaches exhibited lower serum levels of IL-6, CRP, and CK than those receiving LPO after surgery (IL-6: P = 0.007 , CRP: P = 0.001 , CK: P = 0.001 ). The APLCP had a lower total incidence rate of complication than the LPO group (48.00% vs. 18.00%, P = 0.003 ). In conclusion, these data support the notion that the implantation of anatomically precontoured APLCP through a posterior approach allows for improved functional outcomes and attenuated inflammatory response and prevents the incidence of postoperative complications compared to conventional LPO for internal fixation of extra-articular distal humeral fractures.

show abstract

Section: Discussionmentioning

confidence: 99%

Functional Outcome and Inflammatory Response of Patients with Extra-Articular Distal Humeral Fractures following Implantation of Anatomically Precontoured Locking Compression Plates through a Posterior Approach

Liu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

show abstract

“…Based on the results of this study, it was found that IL-6 < 15 pg/ml resulted in better HHS values on day 14 (p=0.016; OR=6.3 (1.325-29.945); 95% CI), as well as day 30 (p=0.015; OR=1.4 (1.005-1.950); 95% CI) after bipolar HA surgery with the percentage of good HHS values of 77.8% (H-14) and 100% (H-30), while the levels of IL-6 15 pg/ml resulted in better HHS values of 35.7% (H-14) and 71.4% (H-30). In a study conducted by [9] surgical techniques with minimally invasive techniques have lower levels of IL-6 and have better HHS. The mean levels of IL-6 obtained were 4.67 + 1.87.…”

Section: Discussionmentioning

confidence: 99%

Lower Creatine Kinase, IL-6 Levels and Femoral Offset Values Lead to Better Outcome Harris Hip Score Post Bipolar Hemiarthroplasty Surgery Day 14 and Day 30

Pramana¹,

Kawiyana²,

Aryana³

et al. 2023

EJMED

View full text Add to dashboard Cite

Bipolar Hemiarthroplasty (HA) procedure allows patients after a neck femur fracture to be able to perform early mobilization. Hence complications due to prolonged bed rest could be prevented. Early mobilization should be achieved immediately after bipolar HA surgery. There are several factors affecting early mobilization in patients, some of which include tissue damage during surgery (creatine kinase), inflammatory status of patients (IL-6) and implant position (femoral offset). This study aims to show whether lower levels of creatine kinase, IL-6 and femoral offset can result in better Harris Hip Score following Bipolar HA surgery day 14 and day 30. By knowing the influencing factors, it is hoped that more accurate management could be carried out. Thus, the outcome parameters of early mobilization in the form of returning to daily life and work activities are getting better and the risk of complications can be avoided. This study compared the Harris Hip Score (HHS) in patients who'd already had Bipolar Hemiarthroplasty using a prospective cohort study design (Bipolar HA) who met the inclusion criteria at the Central General Hospital (RSUP) Prof I.G.N.G Ngoerah Denpasar and provided them informed consent. In order to do descriptive analysis, normality and homogeneity tests, and proportion comparison analysis, the research data was entered into a research sheet and processed using a computer and the SPSS for Windows version 26 program. In this study, the sample data (n=32) was not normally distributed. Lower levels of IL-6 (< 15 pg/ml), and FO values (< 42.5 mm) resulted in better HHS values in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK (< 75 U/L), IL-6 (< 15 pg/ml), and FO values (< 42.5 mm) resulted in better HHS values in patients following bipolar HA surgery on day-30. Chi-Square analysis showed that the results of CK levels day-14 were statistically insignificant (p= 0.072>0.05), while the results of CK levels day-30 were statistically significant (p=0.033<0.05). Moreover, chi-Square analysis showed that the results of day-14 and day-30 were statistically significant on IL-6 levels (p-0.016<0.05 and p= 0.015<0.05), and FO values (p= 0.012<0.05 and p-0.033<0.05). It is concluded that lower levels of IL-6, and FO values resulted in better HHS values in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK, IL-6, and FO values resulted in better HHS values in patients following bipolar HA surgery on day-30.

show abstract

“…The characteristics of included studies are presented in Table I. Seventeen studies including 3,551 patients met the inclusion criteria [10][11][12][13]17,[19][20][21][22][23][24][25][26][27][28][29][30] . The number of patients per study ranged from 20 to 1,341, with a mean age range of 51 to 74 years (Table I).…”

Section: Quality Assessment and Methodologymentioning

confidence: 99%

“…One hundred eighty-one studies were excluded after reviewing duplications using EndNote, and 207 articles were screened by title and abstract, of which 52 articles were eligible for full-text screening. Ultimately, 17 qualifying articles were selected [10][11][12][13]17,[19][20][21][22][23][24][25][26][27][28][29][30] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Considerable heterogeneity in mean operative time was seen (range 57-130 minutes). Six studies compared DSA with PLA mean operative times [11][12][13]24,26,28 : 3 moderate-to-highevidence studies found a shorter operative time for the DSA than for the PLA 11,24,28 , 1 study reported longer operative time for the DSA (90 6 14 minutes) than for the PLA (77 6 20 minutes) 26 , and 2 studies reported no difference in operative time 12,13 THAs, yet a significant decrease in operative time was seen for the second 20 DSA THAs, suggesting a learning curve effect 21 .…”

Section: Operative Timementioning

confidence: 99%

See 1 more Smart Citation

The Direct Superior Approach in Total Hip Arthroplasty

van Dooren,

Peters,

van der Wal-Oost

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

Background: Evolution of the surgical approach for total hip arthroplasty (THA) has led to the development of the minimally invasive direct superior approach (DSA). It is hypothesized that the DSA reduces postoperative pain and hospital length of stay (LOS). We aimed to provide an overview of current evidence on clinical, functional, and radiological outcomes with respect to risk of revision, complications, pain scores, physical function, operative time, LOS, blood loss, radiological outcomes, and learning curve. Methods: A comprehensive search of Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension guidelines, was conducted to identify studies evaluating clinical, functional, and radiological outcomes of the DSA. Quality assessment was performed using the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. The review protocol was prospectively registered in the International Prospective Registry of Systematic Reviews. Results: Seventeen studies were included, generally of moderate quality. Qualitative synthesis evidenced accurate implant positioning, short LOS, and a short learning curve. Conflicting findings were reported for postoperative complications compared with conventional approaches. Better functional outcomes were seen in the early postoperative period than the posterolateral approach (PLA). Outcomes such as blood loss and operative time exhibited conflicting results and considerable heterogeneity. Conclusion: Based on moderate-certainty evidence, it is uncertain if the DSA provides short-term advantages over conventional approaches such as PLA. There is limited evidence on long-term outcomes post-THA using the DSA. Further studies and ongoing registry monitoring is crucial for continuous evaluation of its long-term outcomes. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Comparative prospective randomized study of minimally invasive transpiriformis approach versus conventional posterolateral approach in total hip arthroplasty as measured by biology markers

Cited by 8 publications

References 37 publications

Functional Outcome and Inflammatory Response of Patients with Extra-Articular Distal Humeral Fractures following Implantation of Anatomically Precontoured Locking Compression Plates through a Posterior Approach

Functional Outcome and Inflammatory Response of Patients with Extra-Articular Distal Humeral Fractures following Implantation of Anatomically Precontoured Locking Compression Plates through a Posterior Approach

Lower Creatine Kinase, IL-6 Levels and Femoral Offset Values Lead to Better Outcome Harris Hip Score Post Bipolar Hemiarthroplasty Surgery Day 14 and Day 30

The Direct Superior Approach in Total Hip Arthroplasty

Contact Info

Product

Resources

About