Abstract
BackgroundTotal hip arthroplasty (THA) has been one of the most successful orthopedic procedures over the past 30 years. Nowadays, the techniques of exposure for THA have undergone great changes, allowing surgeons to perform THA through mini-incisions. Recently, a novel minimally invasive surgical technique of the supercapsular percutaneously assisted total hip arthroplasty was reported in 2011. The purpose of this study was to compare the SuperPath approach with the conventional posterior approach, in terms early outcomes and radiologic results.MethodsNinety-two consecutive unilateral primary hip osteoarthritis adult patients were randomly divided into two groups. Forty-six patients (SuperPath group) were operated on using the SuperPath approach, and 46 patients (conventional group) were operated on with the conventional posterior approach. Outcomes were evaluated using preoperative index, intraoperative data, and postoperative function data. The positioning of the implants was analyzed by radiography.ResultsNo significant difference was detected in skin-to-skin operation time, blood loss, transfusion rate, postoperative complications, abduction angle, anteversion angle, and stem alignments. The incision length and length of stay (LOS) in the SuperPath group were significantly lower. The VAS score in the SuperPath group at the 1-week, 1-month and 3-month postoperative intervals were lower than those VAS scores in the conventional group. The Harris Hip Score and Barthel Index (BI) for Activities of Daily Living in the SuperPath group were significantly higher at the 1- and 3-month follow-up intervals and were not significantly different 1 year after operation.ConclusionsThis prospective randomized study reveals that the SuperPath technique was associated with shorter LOS, earlier time to walk and climb, and lower postoperative pain levels. It also allowed early postoperative rehabilitation and faster recovery than conventional technique.
Highlights
Total hip arthroplasty (THA) has been one of the most successful orthopedic procedures over the past 30 years
All patients received the type of treatment to which they had been allocated (Fig. 1), and they were assigned to two groups: group 1: 46 patients were assigned to the SuperPath group and were operated on using the SuperPath approach and group 2: 46 patients were assigned to the conventional group and were operated on using the conventional posterior approach
Functional outcomes were evaluated using the following measures: Harris Hip Score (HHS), Barthel Index (BI), and visual analog scale (VAS) for pain level, TUG, TSC
Summary
Total hip arthroplasty (THA) has been one of the most successful orthopedic procedures over the past 30 years. Total hip arthroplasty (THA) has been regarded as one of the most successful orthopedic reconstructive procedures for improving life quality in patients suffering from both trauma and end-stage degenerative joint disease These conventional surgical approaches for THA have their respective shortcomings [1], including longer incisions, massive tissue damage, increased perioperative blood loss, and delayed postoperative rehabilitation. In an attempt to overcome these disadvantages, a novel MIS technique and initial experience of the supercapsular percutaneously assisted total hip arthroplasty (SuperPath®, MicroPort Orthopedics Inc., Arlington, TN, USA) was reported by Dr James Chow in 2011 [4] This technique was created by combining the percutaneous preparation of the acetabulum through a portal of the PATH approach and the femoral reaming and broaching of the SuperCap approach [5]. Observations of this surgical technique have shown a low complication rate, satisfactory radiographic outcomes, shortened length of hospital stay, and excellent early functional results [6, 7]
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