Estudio comparativo radiológico y funcional del abordaje anterior directo versus abordaje posterolateral de cadera

Abstract

ObjectiveTo compare clinically and radiologically the results obtained using both a direct anterior approach (DAA) and posterolateral (PL) approach in total hip arthroplasty (THA). Material and methodsMulticentric longitudinal prospective study in 80 patients (80 THA). Forty patients underwent total hip arthroplasty through DAA and 40 through a PL approach. The following clinical parameters were collected: anaesthesia, length of surgical incision, duration of the procedure, lower limb discrepancy, pain, complications, hospitalization time, Harris Hip Score (HHS) and subjective patient satisfaction. Radiological measures collected were acetabular tilt angle, acetabular component version, osteointegration and lower limb length. ResultsPostoperative pain: DAA 4points; PL 4.3points. Incision length: DAA 14cm, PL 15cm. Mean hospital stay: DAA 2.8days, PL 3.4days. HHS at 3weeks: DAA 87.5points and PL 84points; at 2months: DAA 92points and PL 91points. Femoral stem subsidence was noticed in 4 patients from DAA and 1 from PL. Malalignment was reported in 9 cases from the DAA group. ConclusionsOur results show an initial advantage of the DAA group regarding functional recovery and pain that enabled shorter hospitalization time. This difference equalled out over 2months following the procedure. Likewise, we detected a greater complication rate in the DAA group using standard cementless stems.