Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study

Abstract

Background This study aims to evaluate postoperative pain and functional and clinical outcomes of anterolateral supine (ALS) and posterolateral (PL) approaches for primary total hip arthroplasty. Materials and methods We retrospectively examined the joints of 110 patients who underwent primary total hip arthroplasty (THA). The ALS group was compared with the PL group using the pain visual analog scale (VAS) and narcotic consumption as pain outcomes. Functional outcomes included postoperative range of motion (ROM) of hip flexion, day on which patients could perform straight leg raising (SLR), day on which patients began using a walker or cane, duration of hospital stay, rate of transfer, and strength of hip muscles. Clinical outcomes included pre and postoperative Harris Hip Scores. Results No significant differences were found in the pain VAS scores or narcotic consumption between the two groups. The PL group could perform SLR earlier than the ALS group (P < 0.01). The ALS group started using a cane earlier (P < 0.01) and had a shorter hospital stay (P < 0.01) than the PL group. Degrees of active ROM of flexion at postoperative day (POD) 1 were significantly lower in the ALS group than in the PL group (P < 0.01). Regarding hip muscle strength, hip flexion was significantly weaker in the ALS group than in the PL group until 1-month POD (P < 0.01). External rotation from 2 weeks to 6 months postoperatively was significantly weaker in the PL group than in the ALS group (P < 0.01). Conclusion The ALS approach was more beneficial than the PL approach because ALS enabled better functional recovery of the strength of external rotation, improved rehabilitation, and involved a shorter hospital stay. Level of Evidence Level IV retrospective observational study.

Differences in preoperative function and outcome of patients with versus without sarcopenia after total hip arthroplasty

“…Yoshimura et al 19) reported that sarcopenia patients showed a lower discharge-tohome rate and lower ADL at discharge. In this study, results were similar to those described by Yoshimura et al Regarding the surgical approach, Ukai et al 20) reported a comparison of ALS and PL approaches, external rotation muscle strength of the hip joint was significantly weaker in the PL approach until half a year postoperatively. In addition, The ALS group started using a cane earlier and showed a shorter hospital stay.…”

“…In addition, The ALS group started using a cane earlier and showed a shorter hospital stay. In this study, both patients in the sarcopenia group were treated using the PL approach, and the surgical techniques might have been affected in a similar manner to those in the study by Ukai et al 20) .…”

“…A combination of exercise and nutritional interventions is recommended for frail elderly and sarcopenic patients 11,12,[19][20][21][22] . Sarcopenia cases in this study were living in the community and preoperative ADL was independent.…”

The role of patient surgical positioning on hip arthroplasty component placement and clinical outcomes: a systematic re-view and meta-analysis

“…4 studies focused more on component placement and outliers of cup alignment [8][9][10][11] , while the other 4 studies evaluated mostly intraoperative and postoperative outcomes. [12][13][14][15] The remaining study 16 was not included in the meta-analysis due to the absence of the researched parameters.…”

Anterolateral approach may be superior to posterolateral approach in controlling postoperative lower limb discrepancy in primary total hip arthroplasty: A single-center, retrospective cohort study

“…[ 10 ] The ALA was performed thought the gluteus medius, which was associated with increased hip load, decreased the dislocation rates,[ 11 ] and reduced length of stay (LOS). [ 12 , 13 ] Currently, the PLA remains the most commonly used in the United States, with an excellent exposure view by damaging joint capsule with shorter duration, lower intraoperative fracture, and higher risk of dislocation. [ 14 ] Overall, the efficacy and comparison between the approaches and the postoperative LLD and offset has not been sufficiently investigated with controversial findings.…”