Early Outcome Comparison of the Posterior Approach and the Superior Approach for Primary Total Hip Arthroplasty

Abstract

Background: The superior approach for total hip arthroplasty (THA) is a minimally invasive, tissuesparing technique that may have clinical and economic benefits. The purpose of this study was to compare early outcomes between the posterior approach and the superior approach in primary THA. Our hypothesis was that the superior approach would have a noninferior length of stay (LOS), discharge destination, and blood loss compared with the posterior approach. Methods: All primary THAs performed by a single surgeon at one institution were retrospectively reviewed over a 2-year period (2015-2017). There were 676 patients, 40.4% of whom underwent a posterior approach and 59.6% underwent a superior approach. LOS, discharge destination, blood loss, and operating room time were analyzed. Gender, body mass index, and American Society of Anesthesiologists status were recorded and controlled. Results: The posterior approach was independently associated with an almost threefold higher risk of prolonged LOS (>2 days, P < .001) (odds ratio: 2.90, 95% confidence interval: 1.87-4.49; P < .001). The mean LOS for the superior approach was 1.71 days vs 2.17 days for the posterior group (P < .001). Fewer patients in the superior approach cohort were discharged to a rehabilitation facility (8.9% vs 17.9%, P < .001). The mean operative time was shorter in the superior group (91.8 vs 95.8, P ¼ .001). There was no statistically significant difference in acute postoperative blood loss. There were no dislocations or reoperations in either group. Conclusions: The superior approach to THA was associated with a significantly shorter length of hospital stay and lower rate of discharge to rehab than the posterior approach. This approach can be used as a safe, minimally invasive, and tissue-sparing variation of a standard posterior approach for THA and has promising early outcomes.

The Method for Identification of Radars Measurements of Nearby Objects Tracking

“…LeRoy T.E. [15] note that with a low probability of the presence of false marks, large distances between objects in relation to measurement errors, the methods of a priori and a posteriori Bayesian data identification give absolutely the same results. In the presence of compact groups of closely spaced objects, from the point of view of classification quality indicators, the posterior method [15] looks preferable.…”

“…Expression (15) represents the optimal decision rule for the method of joint identification of radio engineering measurements while tracking closely spaced objects of observation. The optimal decision rule presupposes an enumeration of hypotheses.…”

Comparative Evaluation of Sequential and Parallel Methods for Identifying Measurements of Nearby Objects

“…LeRoy T.E. [17] proposes the posterior method of classification. It is notes that with the large distances between objects, a low probability of the presence of false objects, the methods of a priori and a posteriori Bayesian data classification give the same results.…”

“…It is notes that with the large distances between objects, a low probability of the presence of false objects, the methods of a priori and a posteriori Bayesian data classification give the same results. The disadvantage of [17] is their complexity. It linearly depends on the number of objects and on the total number of objects.…”

Revision risk by using the direct superior approach (DSA) for total hip arthroplasty compared with postero-lateral approach: early nationwide results from the Dutch Arthroplasty Register (LROI)

“…Outcomes of THA with the DSA have shown that reliable implant positioning can be obtained with a low early complication rate (11)(12)(13). Shorter length of hospital stay and enhanced recovery with higher functional scores were recorded in comparison with the PLA (14)(15)(16)(17)(18)(19). Contrary to the DAA, the learning curve seems to be limited (10)(11)20).…”