Comparison of supercapsular percutaneously assisted approach total hip versus conventional posterior approach for total hip arthroplasty: a prospective, randomized controlled trial

Xie, Jun; Zhang, Hongxi; Wang, Lei; Yao, Xiang; Pan, Zhanpeng; Jiang, Qing

doi:10.1186/s13018-017-0636-6

Cited by 57 publications

(174 citation statements)

References 29 publications

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“…[67] A prospective study of 92 patients randomized to either SuperPATH or the posterior approach THA demonstrated a decreased rate of transfusions with SuperPATH, although the results were not statistically signi cant. [68] Allogenic blood transfusions have been associated with increased risk of infection after total joint arthroplasty, and the SuperPATH approach may help reduce this risk by reducing blood loss. [69] Rapid time to ambulation is a theoretical advantage of MIS THA approaches.…”

Section: Discussionmentioning

confidence: 99%

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Kay¹,

Klavas²,

Haghshenas³

et al. 2020

Preprint

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BACKGROUNDDislocation after primary total hip arthroplasty (THA) has an incidence of 2-3. Approximately 77% of dislocations occur within the first year after surgery. The SuperPATH technique is a minimally invasive approach for THA that preserves soft tissue attachments. The purpose of this study is to describe the dislocation rate at one year after SuperPATH primary THA. METHODSAll elective primary THAs performed by the senior author using the SuperPATH approach. Exclusion criteria were acute femoral neck fracture, revision surgery, or malignancy. There were 214 of 279 eligible patients available for telephone interviews (76.7%). Medical records were reviewed for secondary outcomes including early and late complications, cup positioning, distance ambulated on postoperative day one, discharge destination, and blood transfusions. RESULTSMean age at surgery was 64 ± 10.8 years and mean time to telephone follow up was 773 ± 269.7 days. There were 104 female and 110 male patients. There were zero dislocations reported. Blood transfusions were performed in 3.7% of patients, and 75.7% were discharged to home at an average of 2.3 ± 1.0 days. Cup position averaged 43.6 ± 5.2° abduction and 20.9 ± 6.2° anteversion, with an average leg length discrepancy of 3.6 ± 3.32mm. Complications included three intraoperative calcar fractures, one periprosthetic femur fracture, one early femoral revision, three superficial infections, and one instance of wound necrosis.CONCLUSIONSuperPATH approach is safe for use in primary THA resulting in a low dislocation rate.

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Section: Discussionmentioning

confidence: 99%

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Kay¹,

Klavas²,

Haghshenas³

et al. 2020

Preprint

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“…Rachbauer and colleagues defined "a minimal invasive surgery" with the following characteristics: a short skin incision, preventing muscle splitting and/or detachment, and preserving the joint capsule [34]. Previous studies claimed that the SuperPath, approach as a true tissue-sparing minimally invasive approach, has less muscle damage mainly due to the preservation of external rotators [12,15,16,[35][36][37]. Our data discovered indeed a considerably shorter incision length in the SuperPath approach, however, and identified a noticeably longer operation time, more intraoperative blood loss, and comparable extents of soft tissue damage in the SuperPath approach compared with the PLA approach within the first 2 weeks postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Supercapsular percutaneously-assisted total hip (SuperPath) versus posterolateral total hip arthroplasty in bilateral osteonecrosis of the femoral head: a pilot clinical trial

Meng

Huang

Wang

et al. 2019

Preprint

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Background: The supercapsular percutaneously-assisted total hip arthroplasty (SuperPath) was proposed to be minimally invasive and tissue sparing with possible superior postoperative outcomes to traditional approaches of total hip arthroplasty (THA). Here, we compared the short-term outcomes of staged THA with the SuperPath or through posterolateral approach (PLA) for bilateral osteonecrosis of the femoral head (ONFH). Methods: Patients with bilateral late-stage ONFH were prospectively recruited from our department from March 2017 to March 2018. Staged bilateral THAs with one side SuperPath and the other side PLA were performed consecutively in the same patients with right and left hips alternating within approaches. The average time interval between the staged THAs was 3 months. Perioperative status (operation time, incision length, intraoperative blood loss, soft tissue damage, and length of hospital stay) and postoperative function (range of motion, pain, and hip function) were recorded and compared between the SuperPath and PLA approaches within 12-month postoperatively. Results: Four male patients (age, 51.00 ± 4.54; BMI, 21.49 ± 1.73) with bilateral alcohol-induced ONFH (Ficat III/IV) were followed up over 12 months postoperatively. Compared with the PLA, the SuperPath yielded shorter incision length (7.62 vs. 11.12 cm), longer operation time (103.25 vs. 66.50 min), more blood loss (1108.50 vs. 843.50 ml), deficient abduction angle of the acetabular cup (38.75° vs. 44.50°), and inferior early-term hip function (Harris hip score, 72.50 vs. 83.25) at 12-month postoperatively. Soft tissue damage, length of hospital stay, postoperative pain, postoperative range of motion, and 12-month patient satisfaction were comparable between both approaches. Conclusion: The SuperPath may be a minimally invasive technique but the present study shows less favorable short-term outcomes than PLA for total hip arthroplasty in osteonecrosis of the femoral head. More investigations are required to provide convincing favorable evidences of the SuperPath over other traditional THA approaches.

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“…Preoperatively, all patients routinely underwent preadmission assessment, including radiograph of the pelvis and hip joint, blood tests, electrocardiogram, and anesthesiologist assessments. Inclusion criteria were as follows: (1) patients with body mass index (BMI) < 40 kg/m 2 ; (2) patients without serious functional deformity; (3) patients without the surgical history in affected side hip joint; (4) patients undergoing primary THA.…”

Section: Patientsmentioning

confidence: 99%

“…Total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis and other disorders of femoral neck fracture, femoral head necrosis and acetabular dysplasia [1]. There are 3 main classical approaches to the hip for THA: posterolateral (Kocher-Langenbach), anterolateral (Watson-Jones) and anterior (Smith-Peterson).…”

Section: Introductionmentioning

confidence: 99%

“…Commonly cited modi cations currently include the Direct Anterior Approach (DAA), Anterior Supine Intermuscular approach (ASI or OCM), and modi ed mini-posterior approach. Each of these minimally-invasive approaches has been shown to be safe and effective, if performed outside of its "learning curve" [1]. Each learning curve has been reported to be different based on approach, author and patient population [4].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Learning Curve of Supercapsular Percutaneously-assisted Total Hip Arthroplasty in an Asian Population

Lei

Liao

Jiang

et al. 2020

Preprint

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Background: The supercapsularpercutaneously-assisted total hip (SuperPATH) approach is a micro-invasive approach that was developed to minimize surgical disruption of soft-tissue during routine total hip arthroplasty (THA). This study aimed to assess early outcomes and learning curves of the SuperPATHapproachin one Chinese hospital’s experience.Methods: Early outcomes of the first consecutive 78SuperPATH cases (80 hips) performed by same surgeon were evaluated. The patients were divided into 4 groups according to the surgical order. The incision, intraoperative blood loss, hospital stay, Harris hip score and complications occurrence in each group were evaluated. Learning curves were assessed using operative time and intraoperative blood loss as surrogates.Results:The operation time and intraoperative blood loss of group A and B was more than that of group C and D, and the difference was statistically significant (P<0.05), however there was no statistically significant difference between the two groups (group A vs. group B, P=0.426; group A vs. group B, P=0.426).There was no statistically significant difference in terms of incision length and hospital stay and Harris hip score at the last follow-up was increased with statistically significant difference when compared with that of preoperative among the 4 groups. One case of periprosthetic fracture occurred in group A. No other complication, such as joint dislocation, sciatic nerve injury, prosthesis loosening, periprosthetic infection and deep vein thromboembolism, occurred in 4 groups.Conclusion:In summary, for surgeons who familiar with the standard posterolateral approach, they could achieve more familiar with SuperPATH after 40 case of surgery.

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Comparison of supercapsular percutaneously assisted approach total hip versus conventional posterior approach for total hip arthroplasty: a prospective, randomized controlled trial

Cited by 57 publications

References 29 publications

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Two Year Average Follow Up of Supercapsular Percutaneously Assisted Total Hip Arthroplasty; Zero Dislocations

Supercapsular percutaneously-assisted total hip (SuperPath) versus posterolateral total hip arthroplasty in bilateral osteonecrosis of the femoral head: a pilot clinical trial

Assessment of the Learning Curve of Supercapsular Percutaneously-assisted Total Hip Arthroplasty in an Asian Population

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