Ergebnisse aus Messungen der Bodenreaktionskraft vor und nach Implantation einer Hüfttotalendoprothese bei unterschiedlichen Operationszugängen

Leuchte, S.; Luchs, A.; Wohlrab, David

doi:10.1055/s-2007-960511

Cited by 15 publications

(17 citation statements)

References 12 publications

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“…Leuchte et al [16] untersuchten jeweils 16 Patienten, die eine HTEP über einen anterolateralen minimal-invasiven bzw. transglutäalen Zugang erhielten (einen Tag prä-, 8, 14, und 28 Wochen postoperativ).…”

Section: » Die Ganganalyse Wird Zunehmend Als Beurteilungsmethode Herunclassified

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Ganganalyse nach minimal-invasiver Hüftprothesenimplantation

Sander

Layher

Anders³

et al. 2012

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Upon implantation of a hip prosthesis by total hip arthroplasty (THA), clinical criteria are not always sufficient for an objective assessment of the functional outcome. Thus, functional improvement of gait behavior was comparatively validated by instrumented 3D gait analysis for a current, minimally invasive surgical approach (MIS; anterolateral approach) and a conventional, transgluteal approach (KONV). In selected cases, disturbed motion sequences were registered by measuring the muscle activity via high-resolution, monopolar surface electromyography (S-EMG) above the operation area. Despite continuous and significant improvement of practically all analyzed kinematic and kinetic gait parameters for both surgical approaches already after 5 weeks but in particular after 6 and 12 months, no significant differences were detected between the 2 procedures for any parameter or time point. The S-EMG demonstrated non-physiological muscle activation on the operated, but also on the non-operated side, even at 6 months after surgery. Advantages of the MIS approach thus seem primarily restricted to early, post-operative results, such as more rapid pain reduction and rehabilitation.

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Section: » Die Ganganalyse Wird Zunehmend Als Beurteilungsmethode Herunclassified

“…16 Patienten mit einem direkten anterioren MIS-Zugang prä-und 6 bzw. 12 Wochen postoperativ ganganalytische Zeit-Distanz-Parameter und Gelenkwinkel.…”

Section: » Die Ganganalyse Wird Zunehmend Als Beurteilungsmethode Herunclassified

Ganganalyse nach minimal-invasiver Hüftprothesenimplantation

Sander

Layher

Anders³

et al. 2012

Orthopäde

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“…This is of even greater interest, as some authors observed advantages of the MIS approach only in the early postoperative follow-up period. 8,10 …”

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confidence: 99%

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

et al. 2013

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There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

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“…Dies kam insbesondere im Parameter Standphasendauer zum Ausdruck. Im Gegensatz dazu fanden Leuchte et al[28] signifikant bessere Werte für eine MIS-Gruppe bereits nach 8 und 14 Wochen. Für die vertikale Bodenreaktionskraft waren die Werte nach 5 Wochen im Wesentlichen unverändert (MIS: 104,6 % ±7,8 %; KONV: 102,4 % ±6,9 %).…”

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“…Gruppenspezifische Unterschiede traten nicht auf. Auch Leuchte et al[28] fanden für ihr Patientengut (MISGruppe: anterolateraler vs. Standardgruppe: transglutealer Zugang) keine Differenzen in gangspezifischen Parametern der Bodenreaktionskraft zwischen beiden Gruppen nach 28 Wochen. Im kürzeren Nachuntersuchungszeitraum (8. und 14. postoperative Woche) zeigten ausgewählte Indizes der Bodenreaktionskraft Vorteile für MIS im Seitenvergleich und in der Symmetrie.…”

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Vergleich von minimalinvasivem und transglutealem Zugang zur Implantation von Hüfttotalendoprothesen. Klinik und Ganganalyse

et al. 2011

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Advantages of minimally invasive approaches in total hip replacement which can be found a short time after surgery (like less blood loss, less pain after operation, quicker beginning of mobilisation) were not found in this study 5 weeks later regarding functional outcomes. Persistence of functional deficits, caused by damage to the arthromuscular complex, which occur during the process of the development of the arthrosis, need much more time to recover after surgery, independent of the used approach.

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Ergebnisse aus Messungen der Bodenreaktionskraft vor und nach Implantation einer Hüfttotalendoprothese bei unterschiedlichen Operationszugängen

Abstract: Obviously the immediate post-operative advantages of minimally invasive hip replacement provide better chances for gait rehabilitation compared to the transgluteal approach. Due to the complexity of the problem clinical and gait analysis studies should be linked more closely.

Cited by 15 publications

References 12 publications

Ganganalyse nach minimal-invasiver Hüftprothesenimplantation

Ganganalyse nach minimal-invasiver Hüftprothesenimplantation

A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

Vergleich von minimalinvasivem und transglutealem Zugang zur Implantation von Hüfttotalendoprothesen. Klinik und Ganganalyse

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