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Published on: September 7, 2022
The impact of posterior approach for total hip arthroplasty on early complications
Aashish Gulati1, Amitabh J Dwyer, David L Shardlow
1Department of Trauma & Orthopaedic Surgery, Yeovil District Hospital, Yeovil, Somerset, UK. gulatiaashish@doctors.org.uk
Insights
The posterior approach for total hip arthroplasty is safe and effective, showing excellent patient outcomes and no dislocations in a recent study. This method offers a low rate of early complications, making it a viable option for hip replacement surgery.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
Background:
- The optimal surgical approach for total hip arthroplasty (THA) remains a subject of ongoing debate.
- The posterior approach is recognized for potential benefits like reduced blood loss and improved component positioning.
Purpose of the Study:
- To evaluate the safety and efficacy of the posterior approach in primary total hip arthroplasty.
- To assess patient outcomes, including pain, function, satisfaction, and complication rates, specifically focusing on dislocation incidence.
Main Methods:
- Analysis of 121 consecutive primary total hip arthroplasty patients.
- Data collection included pain scores (1-6), function scores (1-6), satisfaction levels (1-5), and all surgical complications.
- Emphasis was placed on the incidence of dislocation and contributing factors.
Main Results:
- No dislocations occurred in any of the 121 patients.
- 89% of patients reported no or minimal pain post-surgery.
- 73% of patients were mobilizing without walking aids at follow-up.
- 84% of patients rated the outcome as 'very good' at one year.
Conclusions:
- The posterior approach for total hip arthroplasty is associated with a low rate of early complications, particularly dislocation.
- Outcomes in terms of pain, function, and patient satisfaction are comparable to major series using the posterior approach.
- This approach is compatible with excellent functional recovery and high patient satisfaction.
Abstract:
The optimal approach for total hip arthroplasty is hotly debated. We analysed 121 consecutive patients who underwent primary total hip arthroplasty during the first three years of practice of a newly appointed consultant. Patients were analysed for pain scores (1-6), function scores (1-6) and satisfaction levels (1-5). All complications, during and after surgery, were noted with special emphasis on incidence of dislocation and factors contributing to it. The results were gratifying and were comparable with major series of total hip replacement via the posterior approach. No patient had a dislocation. One hundred and five patients (89%) had no or minimal pain after the surgery. Eighty-six patients (73%) were mobilising without a stick. There were no major intra-operative complications and most (84%) patients rated the operation 'very good' at one year follow-up. We conclude that the posterior approach, already known to cause less blood loss and optimum component positioning, is compatible with a low overall rate of early complications especially dislocation.
