Sebastian Seah1, Mark Quinn1, Oren Tirosh1, Phong Tran1. 1. Department of Orthopaedic Surgery, Western Health, Melbourne, Australia; Australian Institute for Musculoskeletal Science, The University of Melbourne and Western Health, St. Albans, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.
Abstract
BACKGROUND: The surgical approach for total hip arthroplasty (THA) has the potential to affect the immediate postoperative recovery; however, there is limited published data comparing the 3 most common surgical approaches. The purpose of the study was to investigate postoperative pain and subsequent opioid consumption between surgical approaches (anterior-AA, lateral-LA, and posterior-PA) in those undergoing primary elective THA. METHODS: A retrospective cohort study assessed patient demographics (age, sex, and body mass index), American Society of Anesthesiologists grade, opioid naivety, operative details (anesthetic method, fixation method, and local infiltration analgesia), pain scores, and length of stay. Statistical analysis was performed with a 1-way analysis of variance 3 × 1 table with a P value < .05. RESULTS: A total of 560 patients were included in the analysis (335 females and 225 males). The cohort consisted of 179 AA, 178 LA, and 203 PA patients. The average postoperative opioid usage was 63.05 (standard deviation [SD] = 42.97), 79.81 (SD = 56.10), and 77.50 (SD = 54.52) oral morphine equivalent daily dose (oMEDD) for the AA, LA, and PA, respectively. The mean difference was 16.8 oMEDD lower in the AA compared with the LA (P < .01) and 14.5 oMEDD lower in the AA compared with the PA (P = .02). CONCLUSION: The direct anterior approach was associated with lower daily opioid usage and pain scores after elective THA in the early postoperative period. This represents a potential 21% reduction in daily opioid dosage when compared with LA patients and 18.7% reduction in PA patients. Crown
BACKGROUND: The surgical approach for total hip arthroplasty (THA) has the potential to affect the immediate postoperative recovery; however, there is limited published data comparing the 3 most common surgical approaches. The purpose of the study was to investigate postoperative pain and subsequent opioid consumption between surgical approaches (anterior-AA, lateral-LA, and posterior-PA) in those undergoing primary elective THA. METHODS: A retrospective cohort study assessed patient demographics (age, sex, and body mass index), American Society of Anesthesiologists grade, opioid naivety, operative details (anesthetic method, fixation method, and local infiltration analgesia), pain scores, and length of stay. Statistical analysis was performed with a 1-way analysis of variance 3 × 1 table with a P value < .05. RESULTS: A total of 560 patients were included in the analysis (335 females and 225 males). The cohort consisted of 179 AA, 178 LA, and 203 PA patients. The average postoperative opioid usage was 63.05 (standard deviation [SD] = 42.97), 79.81 (SD = 56.10), and 77.50 (SD = 54.52) oral morphine equivalent daily dose (oMEDD) for the AA, LA, and PA, respectively. The mean difference was 16.8 oMEDD lower in the AA compared with the LA (P < .01) and 14.5 oMEDD lower in the AA compared with the PA (P = .02). CONCLUSION: The direct anterior approach was associated with lower daily opioid usage and pain scores after elective THA in the early postoperative period. This represents a potential 21% reduction in daily opioid dosage when compared with LA patients and 18.7% reduction in PA patients. Crown
Authors: Kevin Berardino; Austin H Carroll; Daniel Popovsky; Robert Ricotti; Matthew D Civilette; William F Sherman; Alan D Kaye Journal: Orthop Rev (Pavia) Date: 2022-05-31
Authors: Lorenzo Fagotti; Guilherme Guadagnini Falotico; Daniel Augusto Maranho; Olufemi R Ayeni; Benno Ejnisman; Moises Cohen; Diego Costa Astur Journal: Acta Ortop Bras Date: 2021 Nov-Dec Impact factor: 0.513