Does Surgical Approach Affect Patient-reported Function After Primary THA?

作者：Sara C. Graves, Benjamin M. Dropkin, Benjamin J. Keeney, Jon D. Lurie, Ivan M. Tomek · 发表于：Clinical Orthopaedics and Related Research · 年份：2015 · DOI：10.1007/s11999-015-4639-5 · 被引用次数：141 · 研究领域：Orthopaedic implants and arthroplasty、Total Knee Arthroplasty Outcomes、Hip and Femur Fractures

BACKGROUND: Total hip arthroplasty (THA) relieves pain and improves physical function in patients with hip osteoarthritis, but requires a year or more for full postoperative recovery. Proponents of intermuscular surgical approaches believe that the direct-anterior approach may restore physical function more quickly than transgluteal approaches, perhaps because of diminished muscle trauma. To evaluate this, we compared patient-reported physical function and other outcome metrics during the first year after surgery between groups of patients who underwent primary THA either through the direct-anterior approach or posterior approach. QUESTIONS/PURPOSES: We asked: (1) Is a primary THA using a direct-anterior approach associated with better patient-reported physical function at early postoperative times (1 and 3 months) compared with a THA performed through the posterior approach? (2) Is the direct-anterior approach THA associated with shorter operative times and higher rates of noninstitutional discharge than a posterior approach THA? METHODS: Between October 2008 and February 2010, an arthroplasty fellowship-trained surgeon performed 135 THAs. All 135 were performed using the posterior approach. During that period, we used this approach when patients had any moderate to severe degenerative joint disease of the hip attributable to any type of arthritis refractory to nonoperative treatment measures. Of the patients who were treated with this approach, 21 (17%; 23 hips) were lost t...