Early and late results of direct superior approach versus direct lateral approach in total hip arthroplasty – single-center, prospective study

Abstract

Introduction. Total hip arthroplasty (THA) is an established treatment for severe hip osteoarthritis (OA ). Traditionally, surgical approaches involved extensive soft tissue damage. New, less invasive approaches were introduced, facilitating fast recovery, reducing postoperative pain and incision length. Aim. Comparative analysis of postoperative pain and long-term results in patients undergoing total hip arthroplasty (THA) utilizing direct superior approach (DSA) and direct lateral approach (DLA). Materials and methods. Sixty-one patients scheduled for primary THA were included in the study. THA was performed utilizing the approach chosen by experienced orthopedic surgeons. After the procedure, pain intensity and use of analgesics were recorded daily. Patients were contacted 18 months following surgery to collect data on SF-36 score, pain intensity and complications (dislocations, infections, periprosthetic fractures, and revision surgeries). Fifty-two patients were included in the final analysis. Group A (DSA) consisted of 27 patients, whereas group B (DLA) consisted of 25 patients. Results. There were no significant differences between groups in terms of demographic parameters, preoperative pain intensity, Harris Hip Score, and SF-36 score. Significant differences were observed in pain intensity during the first three days post-operation. The use of non-opioid analgesics did not differ; however, the use of tramadol was lower in group A on the 1st and 2nd day post-operation. No significant differences were found in SF-36 score and pain intensity after 18 months post-surgery. Conclusions. DSA approach in THA is superior in comparison with the direct lateral approach in terms of early postoperative pain intensity and use of analgesic drugs. Late results of both approaches are comparable.