Abstract
BackgroundAlthough excellent clinical outcomes of supercapsular percutaneously assisted total hip arthroplasty (SuperPath) have been reported, the peri-operative blood loss has rarely been reported. The current study determined the blood loss during SuperPath and compared the blood loss with conventional posterolateral total hip arthroplasty (PLTH).MethodsThis retrospective study enrolled patients who underwent unilateral primary THA between January 2017 and December 2019. The demographic data, diagnoses, affected side, radiographic findings, hemoglobin concentration, hematocrit, operative time, transfusion requirements, and intra-operative blood loss were recorded. The peri-operative blood loss was calculated using the OSTHEO formula. Blood loss on the 1st, 3rd, and 5th post-operative days was calculated. Hidden blood loss (HBL) was determined by subtracting the intra-operative blood loss from the total blood loss.ResultsTwo hundred sixty-three patients were included in the study, 85 of whom were in the SuperPath group and 178 in the posterolateral total hip arthroplasty (PLTH) group. Patient demographics, diagnoses, affected side, operative times, and pre-operative hemoglobin concentrations did not differ significantly between the two groups (all P > 0.05). Compared to the PLTH group, the SuperPath group had less blood loss, including intra-operative blood loss, 1st, 3rd, and 5th post-operative days blood loss, and HBL (all P < 0.05). Total blood loss and HBL was 790.07 ± 233.37 and 560.67 ± 195.54 mL for the SuperPath group, respectively, and 1141.26 ± 482.52 and 783.45 ± 379.24 mL for the PLTH group. PLTH led to a greater reduction in the post-operative hematocrit than SuperPath (P < 0.001). A much lower transfusion rate (P = 0.028) and transfusion volume (P = 0.019) was also noted in the SuperPath group.ConclusionSuperPath resulted in less perioperative blood loss and a lower transfusion rate than conventional PLTH.
Highlights
Total hip arthroplasty (THA) is an effective treatment option for advanced degenerative and ischemic hip arthropathy
There were no significant differences in age, gender, BMI, diagnoses, and involved side between the SuperPath and the posterolateral total hip arthroplasty (PLTH) groups
In agreement with Sehat et al [21] and Shen et al [22], we found that the surgical blood loss reached a maximum on day 3 postoperatively in the SuperPath and PLTH groups
Summary
Total hip arthroplasty (THA) is an effective treatment option for advanced degenerative and ischemic hip arthropathy. SuperPath uses the interval between the gluteus minimus and piriformis, accesses the capsule from the top, prepares the femur without dislocating the femoral head, and reams the acetabulum through an accessory portal, which preserves capsular attachments and maintains the integrity of the external rotators [8]. This tissue-sparing technique is advocated with reported advantages of a low complication rate, excellent gait kinematics, a low transfusion rate, and a shortened length of hospital stay [9]. The current study determined the blood loss during SuperPath and compared the blood loss with conventional posterolateral total hip arthroplasty (PLTH)
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