Posterior hip approach yields better functional results vis-à-vis anterolateral approach in total hip arthroplasty for patients with severe hip dysplasia: A prospective randomized controlled clinical study

Objectives: We aimed to compare functional outcomes of two common hip approaches for patients with severe hip dysplasia in total hip replacement (THR) surgery. Materials and methods: Seventy hips of 68 patients randomized into two groups with regard to hip approach as posterior (group I) and anterol...

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Published in:Journal of orthopaedic surgery (Hong Kong) 2017-05, Vol.25 (2), p.2309499017717179-2309499017717179
Main Authors: Çatma, Faruk Mehmet, Öztürk, Alper, Ünlü, Serhan, Ersan, Önder, Altay, Murat
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty, Replacement, Hip - methods
Authorship
Dissection
Female
Femur - surgery
Gait
Hip Dislocation - surgery
Humans
Injuries
Joint surgery
Male
Middle Aged
Muscle Strength
Muscle, Skeletal
Operative Time
Osteotomy
Patients
Prospective Studies
Surgery
Treatment Outcome
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Summary:Objectives: We aimed to compare functional outcomes of two common hip approaches for patients with severe hip dysplasia in total hip replacement (THR) surgery. Materials and methods: Seventy hips of 68 patients randomized into two groups with regard to hip approach as posterior (group I) and anterolateral (group II). All patients underwent THR surgery with femoral shortening osteotomy. The groups were compared for operation time, preoperative and 6 months after abductor muscle strengths (AMSs), gait disorders, union time of the osteotomied site and dislocation rates. Results: There were two early dislocations in group I, and two early and one late dislocations in group II. No significant difference was observed regarding hip dislocations. Mean union time of the osteotomied site was 113.9 ± 51 days in group I while 111.1 ± 29.3 days in group II (p = 0.774). Six months after surgery, group I had higher AMS than group II (p < 0.0001). More patients in group II had Trendelenburg gait pattern (p = 0.043), while no difference was observed regarding antalgic and deviated gait patterns between groups. Conclusion: THR surgery for patients with severe developmental dysplasia of hip is a challenging procedure, and posterior approach provides better functional outcomes regarding gait and AMSs.
ISSN:1022-5536
2309-4990
DOI:10.1177/2309499017717179