Hip Abductor Strengths After Total Hip Arthroplasty Via the Lateral and Posterolateral Approaches
Section snippets
Materials and Methods
A total of 722 patients underwent primary THA at our institution between 1997 and 2004. Hips with severe subluxation or dislocation of more than type 2, according to the criteria of Crowe et al [11], were excluded from the study. Patients with neurologic disorders or clear functional and morphological disorders of the knee or spine were excluded. Patients with radiographic abnormalities or functional disorders in their contralateral hips were also excluded. From the remaining 160 patients, 38
Clinical Assessment
The preoperative average Harris hip scores for pain, gait, and activity were 17.7 points (0-30), 21.3 points (0-30), and 10.4 points (5-14) in the lateral group and 17.0 points (0-30), 21.5 points (11-30), and 10.7 points (10-14) in the posterior group, respectively. No significant differences were seen in the preoperative pain, gait, and activity scores between the 2 groups (P = .79, P = .82, and P = .85, respectively). The postoperative average Harris hip scores were 94.2 (82-100) in the
Discussion
Many alternative surgical approaches have been used in THA, and 2 of the most popular are the posterior and lateral approaches. We studied these 2 approaches as they are the 2 most commonly performed procedures in our institution and both provide adequate exposure for THA. These 2 approaches each have advantages and disadvantages.
One of the disadvantages of the lateral approach is the delay in the recovery of hip abductor function. In a review of 770 THAs performed via the lateral approach,
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Influence of Hip Geometry Reconstruction on Frontal Plane Hip and Knee Joint Moments During Walking Following Primary Total Hip Replacement
2019, Journal of ArthroplastyCitation Excerpt :All gait variables were normalized to 100% stance duration, which is the time between the instant of heel-strike (first ground contact) and toe-off (last ground contact). According to many other studies [17–24,32–36], radiographic parameters were determined on routine standardized anteroposterior pelvis and lateral radiographs obtained preoperatively and postoperatively at the same time as the gait analysis with a commercially available templating program, TraumaCad (version 2.3.4.1; Voyant Health, Petach-Tikva, Israel). The FO was defined as the distance between the center of rotation of the femoral head and the central long axis of the femur (Fig. 1) [19].
Patient satisfaction in different approaches for total hip arthroplasty
2019, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :The posterolateral approach on the other hand is still the most frequently used approach, even though this approach violates the posterior hip capsule and muscular structures, which may be associated with increased risk of dislocation. [10],[11] Lastly, the direct lateral approach is accompanied by the risk of abductor weakness caused by damage to the gluteus medius muscle [12]. The patient reported outcome measures (PROMs) gained more popularity by clinicians and investigators in the field of total joint arthroplasty [13].
Posterior or anterolateral approach in hip joint arthroplasty - Impact on frontal plane moment
2018, Clinical BiomechanicsCitation Excerpt :Since the abductor muscles of the hip are divided when utilizing a lateral approach, it is natural to question whether a decreased postoperative function could be partly explained by dysfunction of these muscles. The static strength of the hip abductor complex has been examined in several studies using the Trendelenburg test, in which the patient is asked to keep the pelvis horizontally stabile while performing a one-leg stance (Baker and Bitounis, 1989; Barber et al., 1996; Downing et al., 2001; Edmunds and Boscainos, 2011; Kiyama et al., 2010). Rather than to focus on static strength of a single muscle complex and pelvic stability during one-leg stance, as in the Trendelenburg test, it may be more relevant to examine dynamic frontal plane kinematics and kinetics during gait, by use of 3D motion capture.
Surgical approaches for primary total hip replacement
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No benefits or funds were received in support of the study.