Heterotopic ossification and clinical results after total hip arthroplasty using the anterior minimally invasive and anterolateral approaches

Paweł Łęgosz; Sylwia Sarzyńska; Łukasz Pulik; Piotr Stępiński; Paweł Niewczas; Andrzej Kotela; Paweł Małdyk

doi:10.5114/aoms.2018.78653

Heterotopic ossification and clinical results after total hip arthroplasty using the anterior minimally invasive and anterolateral approaches

Arch Med Sci. 2018 Dec 14;16(3):613-620. doi: 10.5114/aoms.2018.78653. eCollection 2020.

Authors

Paweł Łęgosz¹, Sylwia Sarzyńska¹, Łukasz Pulik¹, Piotr Stępiński¹, Paweł Niewczas¹, Andrzej Kotela², Paweł Małdyk¹

Affiliations

¹ Department of Orthopedics and Traumatology, 1 Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
² Department of Orthopedics and Traumatology, CSK MSW, Warsaw, Poland.

Abstract

Introduction: Total hip arthroplasty (THA) is considered the gold standard in the treatment of advanced osteoarthritis of the hip. The aim of this study was to compare the incidence of heterotopic ossification (HO), the quality of life and the function in two groups of patients who underwent total hip arthroplasty (THA), performed using the anterior minimally invasive (MIS) and the anterolateral approaches.

Material and methods: Retrospective analysis of 597 patients who underwent THA in 2009-2013 was performed. In all 597 cohort data on medical history were retrieved. HO occurrence was recorded for 331 patients and was evaluated based on Brooker's scale in the X-ray scan. Functional and quality of life scores were obtained for 238 patients. The following scales were used for the survey: Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, and Hip and Knee Arthroplasty Satisfaction Scale.

Results: Patients operated on from the MIS approach had statistically significantly (p < 0.05) better results with all the clinical scales used, except the Visual Analogue Scale (p > 0.05). HO was slightly more common after the MIS approach (52.5%) compared to the anterolateral approach (49.76%), though the difference was not statistically significant (p > 0.05).

Conclusions: The MIS approach was associated with better clinical and functional outcomes. In the aspect of HO, we were not able to show the superiority of the MIS approach in terms of incidence.

Keywords: Harris Hip Score; Western Ontario and McMaster Universities Osteoarthritis Index; anterior minimally invasive approach; anterolateral (Watson-Jones) approach; heterotopic ossification; total hip arthroplasty.