Short-term comparison of postural effects of three minimally invasive hip approaches in primary total hip arthroplasty: Direct anterior, posterolateral and Röttinger

Driessche, Stéphane Van; Billuart, Fabien; Martinez, Lucas; Brunel, Héléna; Guiffault, P.; Beldame, Julien; Matsoukis, Jean

doi:10.1016/j.otsr.2016.05.003

Cited by 42 publications

(12 citation statements)

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“…One study reported an increased COP displacement in THA patients 12 days after surgery in comparison to healthy matched controls [ 38 ]. The last study [ 39 ] compared 3 groups of patients within 2 months after surgery, who received 3 different surgical approaches (posterior, anterior and Röttinger approches) and a group of healthy matched controls. No significant differences between approaches were found for fulfilment of the single-limb balance tasks.…”

Section: Resultsmentioning

confidence: 99%

“…However, almost all the studies comparing results of THA patients with healthy controls reports significant differences between-groups, with THA patients have worse balance performance than healthy controls. Impairments have been reported during static [ 38 , 39 , 41 , 44 , 47 , 51 , 63 ] and dynamic balance assessments [ 36 , 54 , 58 ], as well as with the assessment by means of clinical scales or tests batteries [ 41 , 51 , 62 – 64 ].Only 4 studies reported no differences between THA patients and controls in balance during the single-limb phase of walking [ 56 ], the Berg-balance scale results 5 year after surgery [ 62 ], and in response to balance perturbations [ 34 , 58 ]. Further studies with control groups of healthy participants are needed to better clarify these results.…”

Section: Discussionmentioning

confidence: 99%

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Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Labanca

Ciardulli

Bonsanto

et al. 2021

BMC Musculoskelet Disord

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Background Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. Methods A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. Results Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. Conclusion Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Labanca

Ciardulli

Bonsanto

et al. 2021

BMC Musculoskelet Disord

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“…Although it has been reported less pain, narcotic consumption, and higher Harris hip score in patients operated on with the anterior approach, 29 the posterior approach induces only minor muscular trauma and has the least impact on muscle strength and postural parameters the first 2 postoperative months. 19,30 This might explain why there was no between-group difference in postural sway in the TB, as both groups were relatively fit and highly capable of performing the less demanding physical test (i.e., walking at a preferable speed in a walkway in a rested condition). However, in the TA, postural sway was higher in the CR group, which had lower muscular strength in the operated leg than in the MST group.…”

Section: Discussionmentioning

confidence: 99%

“…In combination with reduced muscular strength, postural imbalance might therefore be expected. 18,19 Leijendekkers et al 20 found that muscle strength was significantly reduced after THA compared with muscle strength in healthy subjects and that postoperative trunk lateral flexion asymmetry during gait was evident and differed compared with healthy subjects.…”

mentioning

confidence: 99%

Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients

Winther

Foss

Klaksvik

et al. 2020

Am J Phys Med Rehabil

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The aim of the study was to investigate the effect of maximal strength training on postural sway after total hip arthroplasty, performed before and after a battery of physical performance tests that resemble daily living activities. Design: This study is an exploratory study based on data from a 3-mo randomized controlled trial involving 54 total hip arthroplasty patients performing maximal strength training or conventional rehabilitation. At 3, 6, and 12 mos postoperatively, postural sway was evaluated in two gait tests; ie, one test before and one test after conducting a battery of physical performance tests. Results: At 3 mos postoperatively, postural sway in the test after was significantly higher for the conventional rehabilitation group than the maximal strength training group (P = 0.045); however, there was no between-group difference at the test before (P = 0.670). Postural sway was also significantly higher in the test after compared with the test before in the conventional rehabilitation group (P < 0.001). No difference was found between the test before and test after in the maximal strength training group (P = 0.713). At 6 and 12 mos postoperatively, there were no statistically significant within-or between-group differences in postural sway. Conclusions: Increased muscular strength limits postural sway 3 mos postoperatively in total hip arthroplasty patients after a demanding battery of physical performance tests simulating daily living activities.

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“…There is one study to date which directly compares the mini-AL to the DA approach for THA but only reports on postural control and balance. Van Driessche et al examined the postural control of 15 patients from a DA group, 15 patients from a mini-AL group, and 15 patients from a posterolateral group, and found that the posterolateral approach patients had better postural control at 2 months postoperatively, but reported no data on functional outcomes or complications [21].…”

Section: Discussionmentioning

confidence: 99%

Direct anterior versus mini-anterolateral approach for primary total hip arthroplasty: early postoperative outcomes and complications

et al. 2020

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Background: Anterior-based approaches to primary total hip arthroplasty (THA) are being used more frequently, and several variations have been described. The supine direct anterior (DA) approach has been widely studied, but few studies have compared it with the mini-anterolateral (mini-AL) approach (abductor-sparing, Watson-Jones approach) in the lateral decubitus position. This study aims to compare early perioperative complications and outcomes between these 2 approaches. Methods: This study retrospectively reviewed 340 consecutive THAs (n ¼ 170 DA, n ¼ 170 mini-AL) performed by 3 arthroplasty surgeons at a single institution between January 2017 and May 2018. The primary outcome was reoperation for any reason within 1 year. Secondary outcomes included woundhealing complications and several perioperative factors. A Student's t-test was used for continuous variables, and a chi-squared test was used for categorical variables. Results: In this cohort, 6 patients (4%) from the mini-AL group required reoperation within 1 year, compared with 2 patients (1%) from the DA group (P ¼ .024). However, the DA group had 13 patients (8%) with wound-healing complications compared with 6 patients (4%) in the mini-AL group 4% (P ¼ .036). Perioperative outcomes were similar for operative time, distance walked with physical therapy, morphine milligram equivalent consumed, length of stay, and discharge disposition. Pain scores during index hospitalization were also similar. Conclusions: Patients who underwent THA using the supine DA approach had fewer reoperations within 1 year, but more wound-healing complications compared with the mini-AL approach in the lateral decubitus position. For surgeons performing primary THA using an anterior-based approach, relative risks and benefits of these approaches must be understood.

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Short-term comparison of postural effects of three minimally invasive hip approaches in primary total hip arthroplasty: Direct anterior, posterolateral and Röttinger

Abstract: III, case-control study.

Cited by 42 publications

References 13 publications

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients

Direct anterior versus mini-anterolateral approach for primary total hip arthroplasty: early postoperative outcomes and complications

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