Functional and Clinical outcomes of total hip replacement surgery via Lateral approach
DOI:
https://doi.org/10.61919/jhrr.v4i2.868Keywords:
Total Hip Arthroplasty, Lateral Approach, Blunt Abdominal Trauma, Postoperative Pain, Hip Surgery Outcomes, Surgical Techniques, Orthopedic SurgeryAbstract
Background: Total hip arthroplasty (THA) is a critical surgical intervention for patients with severe hip dysfunction primarily due to conditions such as osteoarthritis, trauma, and other degenerative diseases. The choice of surgical approach can significantly influence the outcomes of the procedure, including postoperative recovery, pain management, and functional mobility.
Objective: This study aims to evaluate the clinical and functional outcomes of the lateral approach in total hip replacement, comparing its efficacy and safety with other surgical techniques.
Methods: A retrospective cohort study was conducted at a single medical teaching institution, involving 74 patients who underwent total hip replacement using the lateral approach between January 2022 and December 2023. Data were collected on patient demographics, surgical details, and postoperative outcomes. Key measures included the Harris Hip Score (HHS), rates of postoperative pain, limb length discrepancy (LLD), and complications such as dislocation and infection. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 25, with a significance threshold set at P < 0.05.
Results: The study population had an equal distribution of male and female patients, with an average age of 57.20 years (SD ± 14.68). Trauma was the most common indication for surgery (67.6%), followed by osteoarthritis (18.9%) and avascular necrosis (9.5%). Postoperative evaluation showed that 62.26% of patients achieved an 'excellent' HHS at two weeks, while 28.38% were rated as 'good'. The overall complication rate was low, with dislocation occurring in 4.1% of cases. Pain was reported in 12.2% of patients post-surgery.
Conclusion: The lateral approach for total hip arthroplasty provides effective pain relief and functional recovery with a low complication rate. This study supports the continued use of the lateral approach as a viable option for hip replacement surgery, showing comparable or superior outcomes to other surgical approaches.
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Sidhdhapuria P, Patel M, Chaudhari N. Study of Functional and Radiological Outcomes of Hip Arthroplasty Via Anterolateral Approach. International Journal of Orthopaedics. 2019;5(3):339-44.
Deshpande S, Bhandari H, Vashishtha S. A Clinical and Functional Outcomes After Modified Harding’s Approach (Antero-Lateral) for Total Hip Replacement. International Journal of Orthopaedics. 2021;7(1):327-35.
Xiong A, Li G, Liu S, Chen Y, Xu C, Weng J, Yu F, Gao L, Wang D, Zeng H. Anterolateral Approach May Be Superior to Posterolateral Approach in Controlling Postoperative Lower Limb Discrepancy in Primary Total Hip Arthroplasty: A Single-Center, Retrospective Cohort Study. Joint Diseases and Related Surgery. 2023 Apr;34(1):32.
Liu H, Yin L, Li J, Liu S, Tao Q, Xu J. Minimally Invasive Anterolateral Approach Versus Direct Anterior Approach Total Hip Arthroplasty in the Supine Position: A Prospective Study Based on Early Postoperative Outcomes. Journal of Orthopaedic Surgery and Research. 2022 Apr 12;17(1):230.
Yang XT, Huang HF, Sun L, Yang Z, Deng CY, Tian XB. Direct Anterior Approach Versus Posterolateral Approach in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Orthopaedic Surgery. 2020 Aug;12(4):1065-73.
Sun X, Zhao X, Zhou L, Su Z. Direct Anterior Approach Versus Posterolateral Approach in Total Hip Arthroplasty: A Meta-Analysis of Results on Early Post-Operative Period. Journal of Orthopaedic Surgery and Research. 2021 Dec;16:1-8.
Gao Z, Huang J, Chen X, Gao Y, Risitano S, Oremus K, Zheng J, Jin Y. The Minimally Invasive Anterolateral Approach Promotes Faster Rehabilitation Than the Lateral Approach After Total Hip Arthroplasty: A Retrospective Case-Control Study of Asian Patients.
Peng L, Zeng Y, Wu Y, Zeng J, Liu Y, Shen B. Clinical, Functional and Radiographic Outcomes of Primary Total Hip Arthroplasty Between Direct Anterior Approach and Posterior Approach: A Systematic Review and Meta-Analysis. BMC Musculoskeletal Disorders. 2020 Dec;21:1-3.
Maldonado , Kyin C, Walker-Santiago R, Rosinsky PJ, Shapira J, Lall AC, Domb BG. Direct Anterior Approach Versus Posterior Approach in Primary Total Hip Replacement: Comparison of Minimum 2-Year Outcomes. Hip International. 2021 Mar;31(2):166-73.
Castioni D, Galasso O, Iannò B, Mercurio M, Gasparini G. Posterior Versus Lateral Surgical Approach: Functionality and Quality of Life After Total Hip Arthroplasty in a Matched Cohort Study. BMC Musculoskeletal Disorders. 2021 Nov;22:1-9.
Abdülhalim AK, Erdem AC, Turgut N, Uyar AÇ, Bayam L, Erdem M. At Least Four-Year Follow-Up Results of Total Hip Replacement Surgery Using a Direct Anterior Approach. Sakarya Tıp Dergisi.;13(1):19-26.
Wu H, Cheng WD, Jing J. Total Hip Arthroplasty by Direct Anterior Approach in the Lateral Position for the Treatment of Ankylosed Hips. European Journal of Orthopaedic Surgery & Traumatology. 2020 Aug;30:993-1001.
SK MA, Chana M, Garg AK, Ghosh S, Kumar S, Hazra S. Comparative Analysis of Functional Outcome of Lateral Versus Posterior Approach in Total Hip Replacement. Int J Acad Med Pharm. 2023;5(1):661-9.
Chen W, Sun JN, Zhang Y, Zhang Y, Chen XY, Feng S. Direct Anterior Versus Posterolateral Approaches for Clinical Outcomes After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Journal of Orthopaedic Surgery and Research. 2020 Dec;15:1-4.
Lazaru P, Bueschges S, Ramadanov N. Direct Anterior Approach (DAA) Vs. Conventional Approaches in Total Hip Arthroplasty: A RCT Meta-Analysis with an Overview of Related Meta-Analyses. PLoS One. 2021 Aug 24;16(8):e0255888.
Jin Z, Wang L, Qin J, Hu H, Wei Q. Direct Anterior Approach Versus Posterolateral Approach for Total Hip Arthroplasty in the Treatment of Femoral Neck Fractures in Elderly Patients: A Meta-Analysis and Systematic Review. Annals of Medicine. 2023 Dec 12;55(1):1378-92.
Patel M, Sidhdhapuria P, Menon H, Chaudhari N. Comparison of Functional Outcomes of Hip Arthroplasty Via Posterior and Lateral Approach. International Journal of Orthopaedics. 2019 Jun;5(3):278-84.
Dharmayuda CG, Kawiyana IK, Astawa P, Suyasa K, Dusak IW, Deslivia MF, Febyan DG. Direct Lateral Versus Posterior Approach in Patients Undergoing Hip Arthroplasty: Short Term Functional Outcome and Review of Recent 5-Year Literature. Jurnal Orthopaedi dan Traumatologi Indonesia-The Journal of Indonesian Orthopaedic & Traumatology. 2021 Dec;4(3).
Gurung S, Langshong R, Rajkumar Raghuwanshi S, Sardar AK, Khomam SS, Kharshiing IS. To Compare the Functional Outcomes Between the Direct Lateral Approach and the Posterior Approach in Hip Arthroplasty. Int J Acad Med Pharm. 2023;5(6):1087-93.
Ramavtar DL, Kumar P, Singh A. Comparison of the Early Functional Outcome Between Lateral and Posterior Approaches in Total Hip Arthroplasty. International Journal of Orthopaedics. 2021;7(3):155-60.
Gharanizade K, Karimi Heris H, Abolghasemian M, Joudi S, Hassany Shariat Panahy P, Yoosefzadeh A. A Comparative Evaluation of Primary Total Hip Arthroplasty Via Lateral and Posterolateral Approaches. Journal of Research in Orthopedic Science. 2016 Feb 10;3(1):0-.
Docter S, Philpott HT, Godkin L, Bryant D, Somerville L, Jennings M, Marsh J, Lanting B. Comparison of Intra and Post-Operative Complication Rates Among Surgical Approaches in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Journal of Orthopaedics. 2020 Jul 1;20:310-25.
Witzleb WC, Stephan L, Krummenauer F, Neuke A, Günther KP. Short-Term Outcome After Posterior Versus Lateral Surgical Approach for Total Hip Arthroplasty-A Randomized Clinical Trial. European Journal of Medical Research. 2009 Dec;14:256-63.
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Copyright (c) 2024 Shams Ur Rehman, Shah Fahad Qayyum, Hamza Khan, Azeem Khan, Muhammad Aamir
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