Surgical Approach to the Hip: Direct Lateral Approach

2009 ◽  
Vol 21 (4) ◽  
pp. 283
Author(s):  
Dong Ok Kim ◽  
Wan Lim Kim ◽  
Kang Sup Yoon
Keyword(s):  
Surgical Approach ◽  
Lateral Approach ◽  
Direct Lateral Approach

scholarly journals Instability in Patients with Lumbar Spine Disease or Fusion Undergoing Posterior Approach vs. Lateral Approach Primary Total Hip Arthroplasty

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Amritdev Parihar ◽  
Evan R. Deckard ◽  
Leonard T. Buller ◽  
R. Michael Meneghini
Keyword(s):  
Lumbar Spine ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Spine Pathology ◽  
Direct Lateral Approach ◽  
Postoperative Dislocation ◽  
Spine Disease

Background and Hypothesis:  Dislocation rates after total hip arthroplasty (THA) in patients with fixed spinopelvic motion due to lumbar spine disease or fusion have been reported as high as 20%. Few studies exist that compare dislocation rates in patients with spine pathology undergoing THA via different surgical approaches. The purpose of this study was to compare postoperative dislocation rates in patients with lumbar spine disease or fusion between those undergoing a primary THA using a posterior versus direct lateral surgical approach.    Experimental Design or Project Methods:  With IRB approval, 1,205 primary THAs performed by two surgeons were retrospectively reviewed. One surgeon routinely performs THAs with a posterior approach while the other surgeon routinely uses a direct lateral approach. Chart review from the electronic medical record was conducted to identify patients who have lumbar spine disease or a lumbar spine fusion. Dislocations for patients with and without lumbar spine disease were compared by posterior approach and direct lateral approach.    Results:   767 posterior approach and 431 direct lateral approach THAs were available for analysis.  43.6% of all THAs had lumbar spine pathology (337/767 posterior and 185/431 direct lateral). The overall dislocation rate was 1.26% (15/1195).  The main predictors of dislocation in binary logistic regression were the presence of lumbar spine pathology (OR 5.24, 95% CI: 1.47–18.69, p=0.018) and posterior surgical approach (OR 7.93, 95% CI: 1.04–60.6, p=0.046).  The dislocation rate for direct lateral approach THAs with lumbar spine pathology was significantly lower compared to posterior approach THAs with lumbar spine pathology (0.0% vs 3.6%, p=0.011).    Conclusion and Potential Impact:   Although there were few dislocations, the study results suggest a direct lateral approach for primary THA may be beneficial to reduce postoperative dislocation for patients with limited spinopelvic motion due to lumbar spine pathology. 

scholarly journals Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

2021 ◽  
Vol 10 (6) ◽  
pp. 1235
Author(s):  
Michael Fuchs ◽  
Marie-Anne Hein ◽  
Martin Faschingbauer ◽  
Mirco Sgroi ◽  
Ralf Bieger ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lateral Approach ◽  
Short Stem ◽  
Abductor Muscle ◽  
Total Hip ◽  
Straight Stem ◽  
Direct Lateral Approach

Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

SURGICAL APPROACH FOR KNEE JOINT ARTHROPLASTY IN CHILDREN WITH CANCER: THE INTRODUCTION OF A LATERAL APPROACH FOR SEGMENTAL RESECTION OF THE PROXIMAL TIBIA

2021 ◽  
Vol 100 (3) ◽  
pp. 227-233
Author(s):  
N.A. Bolshakov ◽  
◽  
A.Yu. Artemov ◽  
A.S. Slinin ◽  
E.O. Bezdolnova ◽  
...  
Keyword(s):  
Knee Joint ◽  
Surgical Approach ◽  
Ewing’S Sarcoma ◽  
Rating Scale ◽  
Ewing's Sarcoma ◽  
Functional Results ◽  
Lateral Approach ◽  
Joint Arthroplasty ◽  
Lateral Side ◽  
Significant Difference

The aim of the study was to analyze our own experience of using the lateral approach in knee joint arthroplasty in children with oncopathology. Materials and methods of research: the results of a retrospective nonrandomized uncontrolled single-center study are analyzed, within the framework of which 97 endoprosthetics of the knee joint were performed in children and adolescents with oncological pathology over 7 years (2012–2018). Lateral approach was used in 28 patients. The functional results were assessed using the MSTS rating scale 6 and 12 months after the surgery. Postoperative complications were analyzed according to the Henderson classification (modified by the ISOLS committee). Results: when comparing the functional outcome depending on the surgical approach, no statistically significant difference was found either after 6 months (p=0,124) or after 12 months (p=0,755). There is no more frequent development of complications detected (p=0,551). The access used also did not affect overall survival in osteosarcoma (p=0,577), in Ewing's sarcoma (p=0,493), as well as on event-free survival in osteosarcoma (p=0,829) and in Ewing's sarcoma (p=0,886). Conclusion: the use of the lateral surgical approach for knee arthroplasty in children with oncopathology does not affect the treatment results, however, it provides the surgeon with greater variability of actions during preoperative planning. This is especially true for patients whose biopsy tract is located on the lateral side.

Implant Survival After Minimally Invasive Anterior or Anterolateral Vs. Conventional Posterior or Direct Lateral Approach

2017 ◽  
Vol 99 (10) ◽  
pp. 840-847 ◽  
Author(s):  
Knut Erik Mjaaland ◽  
Svein Svenningsen ◽  
Anne Marie Fenstad ◽  
Leif I. Havelin ◽  
Ove Furnes ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lateral Approach ◽  
Implant Survival ◽  
Direct Lateral Approach
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