Direct anterior approach THA yielded less atrophy vs direct lateral, posterior approaches
Patients who underwent the direct anterior approach during total hip arthroplasty had less atrophy of the hip musculature compared with those who had direct lateral or posterior approaches, according to published results.
Researchers categorized 25 hips in patients who underwent primary unilateral THA for severe osteoarthritis in groups based on surgical approach, including direct anterior (n=9), direct lateral (n=9) and posterior (n=7). Researchers collected SF-12 questionnaires, WOMAC questionnaires and Harris Hip Scores preoperatively and at 6- and 12-weeks and 1-year postoperatively. Researchers also collected MRI at 24-weeks postoperatively to assess atrophy/fatty infiltration of the hip musculature.
Results showed no significant differences in terms of patient-reported outcome measures between surgical approaches preoperatively and at 1-year postoperatively. Researchers noted significantly lower atrophy readings in the gluteus medius, gluteus minimus, iliacus, obturator externus, pectineus, psoas, quadratus femoris and sartorius muscle groups with the direct anterior approach compared with the direct lateral approach. The direct anterior approach group also had lower atrophy readings in the gluteus medius, iliacus, obturator externus, pectineus, psoas, sartorius and tensor fascia lata vs. the posterior approach group, according to results. Although the posterior approach had lower intensity values in the gluteus medius, gluteus minimus, iliacus, obturator externus, obturator internus, psoas and quadratus femoris compared with the direct lateral approach group, researchers found less atrophy in the pectineus and vastus intermedius after the direct lateral approach group vs. the posterior approach group.
“The observed results confirm the authors’ hypothesis that, when compared with the direct lateral and posterior approaches, the direct anterior approach results in less fatty infiltration of the hip musculature,” the authors wrote.
Collapse
Read more about