Supercapsular percutaneously assisted total hip arthroplasty versus conventional posterior approach: Comparison of early functional results

Acta Orthop Traumatol Turc. 2020 Sep;54(5):511-515. doi: 10.5152/j.aott.2020.19290.

Abstract

Objective: This study aimed to explore the early functional results of total hip arthroplasty (THA) using the supercapsular percutaneously assisted total hip (SuperPATH) microposterior approach.

Methods: In this retrospective study, 58 patients treated with THA from October 2015 to April 2016 in our hospital were enrolled. A total of 28 patients (11 men and 17 women; mean age: 74.95±7.06 years) were operated on using the SuperPATH approach (group 1), and the remaining 30 patients (12 men and 18 women; mean age: 75.63±7.89 years) were operated on using the conventional posterior approach (group 2). To summarize the early functional results of the SuperPATH approach, we retrospectively analyzed the following demographics, perioperative factors, and measures of joint function: age, sex, preoperative diagnosis, preoperative visual analog scale (VAS) for pain, body mass index, the American Society of Anesthesiologists physical status, operation time (skin-to-skin), intraoperative bleeding, incision length, postoperative VAS, Harris Hip Score (HHS), Barthel Index (BI), length of hospital stay, positioning of the implants, and postoperative complications.

Results: All 58 operations were successfully completed, and the average follow-up time was 45 (45.03±2.44) months. The patients in group 1 had shorter incision length (8.84±0.59 versus 13.26±2.41 cm) and length of stay (7.86±0.51 versus 10.80±1.93 days), lower postoperative VAS score (2.43±0.69 versus 3.13±0.94), and better postoperative HHS (88.37±4.31 versus 83.81±6.00) and BI (91.47±5.27 versus 83.59±6.83) at 3 months than the patients in group 2; however, group 1 patients had longer operation time (113.95±25.36 versus 87.22±25.43 min) than group 2 patients (all P<0.05). No significant intergroup differences were found with respect to intraoperative bleeding, cup abduction angle, anteversion angle, and stem positioning. During the follow-up, no deep venous thrombosis, postoperative infection, and hip dislocation were observed in any patient.

Conclusion: Compared with the conventional posterior approach, the SuperPATH approach provided better early functional results with less postoperative pain and shorter hospitalization time. However, the operation time was longer in the SuperPATH approach group.

Level of evidence: Level III, Therapeutic study.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / methods*
  • Comparative Effectiveness Research
  • Enhanced Recovery After Surgery*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Operative Time*
  • Outcome and Process Assessment, Health Care
  • Pain, Postoperative* / etiology
  • Pain, Postoperative* / prevention & control
  • Recovery of Function
  • Retrospective Studies