Direct superior approach for total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Surgical Approaches

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint pathology.
• Surgical approach selection impacts patient outcomes and recovery.
• Direct superior approach (DSA) and posterolateral approach (PLA) are established THA techniques.

Purpose of the Study:

• To compare clinical, radiological, and patient-reported outcome measures (PROMs) between DSA and PLA in THA.
• To evaluate the safety and efficacy of the DSA compared to the PLA.
• To assess outcomes in the first 100 consecutive DSA THA patients versus a matched PLA group.

Main Methods:

• Retrospective single surgeon study comparing 100 DSA THA patients with a matched PLA group.
• Analysis of patient demographics, length of stay, operating time, and complications.
• Assessment of pain, satisfaction, Oxford Hip Score (OHS), leg length discrepancy, and component positioning via radiographs.

Main Results:

• DSA group demonstrated a shorter length of hospital stay and faster discharge from physiotherapy.
• No significant differences were found in operating time, early pain levels, OHS, or patient satisfaction.
• Component positioning (acetabular inclination and anteversion) showed differences, but leg length discrepancy was similar between groups.

Conclusions:

• The direct superior approach (DSA) for THA is safe and comparable to the posterolateral approach (PLA) regarding PROMs and complications.
• Further randomized controlled trials are needed to formally evaluate functional outcomes of the DSA.
• The DSA shows potential for improved early recovery metrics like hospital stay duration.