Literature DB >> 35821937

Similar Outcomes Achieved Between Anterior and Posterior Approach Total Hip Arthroplasty Using Dual Mobility Implants.

Vivek Singh1, Jeremiah Thomas1, Jerry Arraut1, Christian T Oakley1, Joshua C Rozell1, Roy I Davidovitch1, Ran Schwarzkopf1.   

Abstract

Background: Dual mobility (DM) bearings for total hip arthroplasty (THA) have been proposed to reduce the risk of instability in high-risk patients; however, their utility in primary THA remains relatively unexplored. No previous reports have described whether surgical approach influences outcomes associated with DM implant systems. This study aims to compare patient reported outcomes and post-operative groin pain between patients undergoing anterior approach versus posterior approach following primary THA with DM implants.
Methods: We retrospectively reviewed all patients who underwent primary THA and received a DM implant between 2011-2021. Patients were stratified into two cohorts based on surgical approach (anterior vs. posterior approach). Primary outcomes included the presence of substantial postoperative groin pain as well as readmission and revision rates. Demographic differences were assessed using chi-square and independent sample t-tests. Outcomes were compared using multilinear and logistic regressions.
Results: Of the 495 patients identified, 55 (11%) underwent THA via the anterior approach and 440 (89%) via the posterior approach. Surgical time (100.24 vs. 109.42 minutes, p=0.070), length of stay (2.19vs.2.67 days,p=0.072), discharge disposition (p=0.151), and significant postoperative groin pain (1.8%vs.0.7%,p=0.966) did not statistically differ between the cohorts. 90-day readmission (9.1%vs.7.7%,p=0.823) and revision rate (0.0%vs.3.0%,p=0.993) did not significantly differ as well. Specifically, readmission (p=0.993) and revision (p=0.998) for instability did not significantly differ between the cohorts. We found no statistical difference in HOOS, JR (p=0.425), VR-12 PCS (p=0.718), and VR-12 MCS (p=0.257) delta score improvement from preoperative to 1-year follow-up between the two groups.
Conclusion: Comparable outcomes following implantation of DM constructs may be achievable irrespective of the surgical approach employed. The incidence of iliopsoas injections for groin pain did not significantly differ between anterior and posterior approaches. Future investigation is needed to determine whether surgical approach influences long-term outcomes in patients receiving DM implants. Level of Evidence: III.
Copyright © The Iowa Orthopaedic Journal 2022.

Entities:  

Keywords:  direct anterior approach; dual mobility; outcomes; posterior approach; surgical approach; total hip arthroplasty

Mesh:

Year:  2022        PMID: 35821937      PMCID: PMC9210419     

Source DB:  PubMed          Journal:  Iowa Orthop J        ISSN: 1541-5457


  32 in total

Review 1.  The evolution of outcomes and indications for the dual-mobility cup: a systematic review.

Authors:  Cécile Batailler; Camdon Fary; Régis Verdier; Thierry Aslanian; Jacques Caton; Sebastien Lustig
Journal:  Int Orthop       Date:  2016-12-21       Impact factor: 3.075

2.  Forgotten Joint Score in THA: Comparing the Direct Anterior Approach to Posterior Approach.

Authors:  Vivek Singh; Stephen Zak; Ran Schwarzkopf; Roy Davidovitch
Journal:  J Arthroplasty       Date:  2020-04-27       Impact factor: 4.757

3.  Dual mobility cups: an effective prosthesis in revision total hip arthroplasties for preventing dislocations.

Authors:  Julio J Jauregui; Todd P Pierce; Randa K Elmallah; Jeffrey J Cherian; Ronald E Delanois; Michael A Mont
Journal:  Hip Int       Date:  2015-09-09       Impact factor: 2.135

Review 4.  Outcomes of dual mobility components in total hip arthroplasty: a systematic review of the literature.

Authors:  B Darrith; P M Courtney; C J Della Valle
Journal:  Bone Joint J       Date:  2018-01       Impact factor: 5.082

5.  Mid-Term Outcomes of Dual Mobility Acetabular Cups for Revision Total Hip Arthroplasty.

Authors:  Steven F Harwin; Assem A Sultan; Anton Khlopas; Morad Chughtai; Nipun Sodhi; Nicolas S Piuzzi; Michael A Mont
Journal:  J Arthroplasty       Date:  2017-12-14       Impact factor: 4.757

6.  No Difference in Dislocation Seen in Anterior Vs Posterior Approach Total Hip Arthroplasty.

Authors:  Joseph D Maratt; Joel J Gagnier; Paul D Butler; Brian R Hallstrom; Andrew G Urquhart; Karl C Roberts
Journal:  J Arthroplasty       Date:  2016-03-15       Impact factor: 4.757

7.  A comparison of clinical, radiographic and surgical outcomes of total hip arthroplasty between direct anterior and posterior approaches: a systematic review and meta-analysis.

Authors:  Fangteng Jia; Bin Guo; Feixiang Xu; Yuechao Hou; Xiongfeng Tang; Lanfeng Huang
Journal:  Hip Int       Date:  2018-12-31       Impact factor: 2.135

8.  Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results.

Authors:  Sachiyuki Tsukada; Motohiro Wakui
Journal:  Open Orthop J       Date:  2015-05-15

9.  Total hip arthroplasty via the direct anterior approach with a dual mobility cup for displaced femoral neck fracture in patients with a high risk of dislocation.

Authors:  Hironori Ochi; Tomonori Baba; Yasuhiro Homma; Mikio Matsumoto; Taiji Watari; Yu Ozaki; Hideo Kobayashi; Kazuo Kaneko
Journal:  SICOT J       Date:  2017-10-06

10.  A systematic review and meta-analysis of direct anterior approach versus posterior approach in total hip arthroplasty.

Authors:  Zhao Wang; Jing-Zhao Hou; Can-Hua Wu; Yue-Jiang Zhou; Xiao-Ming Gu; Hai-Hong Wang; Wu Feng; Yan-Xiao Cheng; Xia Sheng; Hong-Wei Bao
Journal:  J Orthop Surg Res       Date:  2018-09-06       Impact factor: 2.359

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