Total Hip Arthroplasty through the Mini-Incision (Micro-Hip) Approach versus the Standard Transgluteal (Bauer) Approach: A Prospective, Randomised Study

Dienstknecht, Thomas; Lüring, C.; Tingart, Markus; Grifka, Joachim; Sendtner, Ernst

doi:10.1177/230949901402200210

Cited by 26 publications

(30 citation statements)

References 31 publications

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“…A total of 2925 studies were excluded due to not matching the selection criteria. In the end, nine studies were included in the review [ 8 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nine randomized controlled trials (RCTs) were analyzed in this systematic review [ 8 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. Four of them compared DAA to the standard lateral approach (LA) [ 8 , 21 , 22 , 27 ], three of them compared DAA to the standard posterior approach (PA) [ 19 , 24 , 28 ], and two compared DAA to the posterolateral approach (PLA) [ 25 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

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The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches

Stolarczyk

Stępiński

et al. 2021

JCM

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Total hip arthroplasty (THA) is currently considered the most effective treatment for end-stage hip osteoarthritis (OA). The surgery can be performed via a number of different approaches, including direct anterior (DAA; Smith–Petersen; Hueter), anterolateral (ALA; Watson–Jones), direct lateral (LA; Bauer), posterior (PA; Kocher–Langenbeck), and posterolateral (PLA). There is still a dispute over the optimal technique. The aim of this systematic review was to assess how different surgical approaches toward a THA influence the prosthesis elements’ positioning. We conducted a literature search of Scopus, ScienceDirect, PubMed, Embase, and The Cochrane Library. We evaluated studies in terms of the first author’s name, country, publication year, type of surgical approach being compared to the direct anterior approach, any significant differences at baseline, sample size, and radiographic analysis. A subanalysis of each approach in comparison to the DAA revealed differences in terms of all analyzed implant positioning radiographic parameters. There is still an insufficient number of randomized controlled studies that include radiological analyses comparing THRs (total hip replacements) performed using DAA with other approaches. Implant placement is a crucial step during a THR and surgeons must be aware that the approach they use might impact their judgment on angles and spaces inside the joint and thus alter the implant positioning.

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“…A total of 2925 studies were excluded due to not matching the selection criteria. In the end, nine studies were included in the review [ 8 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches

Stolarczyk

Stępiński

et al. 2021

JCM

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“…Furthermore, MISLA approach was associated with shorter operating time, less blood loss and better functional results (HHS and WOMAC score) on the day of discharge, 6 weeks and 3 months postoperatively [53]. In 2014 Dienstknecht et al (2014) compared muscle damage between conventional lateral, transgluteal approach (Bauer) (LA) and mini-incision (MIS-LA) approach with CRP and CK markers. Serum markers were measured at 2 nd and 7 th POD.…”

Section: Lateral Approach Versus Minimally Invasive Lateral Approachmentioning

confidence: 99%

Muscle Damage in Different Approaches in Total Hip Arthroplasty According to Serum Markers

Tottas¹,

Fiska²,

Kougioumtzis³

et al. 2019

TOORTHJ

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Background:Total Hip Arthroplasty (THA) is the final treatment of end-stage hip osteoarthritis. Nowadays, THA has become very common, cost- effective and one of the most successful orthopaedic procedures. Recently, surgeons have shifted their interest to approaches according to Minimally Invasive Surgery (MIS). These approaches are either modifications of conventional approaches or they are designed from the beginning as MIS approaches. Muscle damage and soft tissue damage are issues that concern researchers who perform studies on THA.Objective:The aim of this study is to review the literature concerning studies by comparing different approaches using serum and inflammatory markers for muscle and soft tissue damage.Methods:We searched the PubMed database in the English language systematically for clinical studies or reviews, comparing muscle damage according to serum markers between two or more approaches in primary total arthroplasty.Results:In total, twenty-one studies were included in this review. Although the results are controversial, it seems that MIS approaches in most of the studies were related to lower levels of inflammation markers contrasting with conventional approaches. Nevertheless, this difference in muscle damage is not correlated with a difference in functional scores or other perioperative data and clinical outcomes in all studies.Conclusion:The existing literature does not lead to a safe consensus about the superiority of any approach. Therefore, there is still a need for further research with well-designed studies.

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“…As previously mentioned, the posterior approach is associated with a risk of dislocation but this finding has not been compared specifically to the direct lateral approach 6 . Pain assessments, although a subjective measure, have also indicated that patients who undergo THA through a lateral approach experience more discomfort than those undergoing a DAA 43,44 , narcotic analgesic use was also reported to be increased in patients who underwent PA compared with the DAA 45 . There does not appear to be a significant difference between the PA and direct lateral approaches peri-operatively, however pain levels during recovery for both are slightly elevated compared to the DAA which is likely due to the relatively muscle-sparing approach of this latter technique.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

The influence of surgical approach on outcomes of total hip arthroplasty

Tadross¹,

Lunn²,

Redmond³

et al. 2016

Orthopaedics and Trauma

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The vast majority of total hip arthroplasties performed in the UK are undertaken using either a posterior or direct lateral approach. This review describes the functional outcomes of these approaches. Functional outcome can be assessed through motion capture of function, strength testing of muscle groups around the hip and imaging of anatomical structures. Regardless of surgical approach, total hip arthroplasty patients rarely -matched controls. The direct lateral approach is associated with abductor deficiencies whilst the posterior approach may introduce extension and rotation deficits. How long functional differences persist between surgical approaches is unclear. The emergence of improved imaging technologies as well as isokinetic dynamometry (muscle strength testing) and 3D biomechanical modelling provide more comprehensive evaluations than traditional post-operative assessments such as radiology or couch examination. Targeted physiotherapy has been suggested as a possible intervention to counter lasting functional deficits. This review provides a foundation to inform surgeons of the impact of each approach to justify their surgical practice and may inform physical rehabilitation regimens postsurgery.

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Total Hip Arthroplasty through the Mini-Incision (Micro-Hip) Approach versus the Standard Transgluteal (Bauer) Approach: A Prospective, Randomised Study

Cited by 26 publications

References 31 publications

The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches

The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches

Muscle Damage in Different Approaches in Total Hip Arthroplasty According to Serum Markers

The influence of surgical approach on outcomes of total hip arthroplasty

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