Comparison of effectiveness between SuperPATH approach and posterolateral approach in total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YUAN Hongmou , ZHU Jiajun , SUN Zhenguo ,  ZHANG Zhiyu

Department of Orthopedics, the Fourth Affiliated Hospital of China Medical University, Shenyang Liaoning, 110032, P.R.China;

Corresponding author：

ZHANG Zhiyu, Email: 2734891336@qq.com

Keywords：

Total hip arthroplasty; SuperPATH approach; posterolateral approach; minimally invasive procedure

DOI：

10.7507/1002-1892.201707121

Video：

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Objective To compare the effectiveness between SuperPATH approach and posterolateral approach in total hip arthroplasty (THA). Methods Between January 2016 and December 2016, 84 patients with hip disease were included in the study and randomly divided into 2 groups. Forty patients were treated with THA via SuperPATH approach (SuperPATH group), and 44 patients were treated with THA via posterolateral approach (PSA group). There was no significant difference in gender, age, body mass index, the type of disease, the complicating diseases, and preoperative thrombosis of lower extremity and Harris score between 2 groups (P>0.05). The operation time, intraoperative blood loss, length of incision, postoperative drainage volume, unloaded activity time, Harris score, and short-form 36 health survey scale (SF-36) score were compared. The postoperative X-ray films were used to observe the position of joint prosthesis. Results All patients were followed up 6-18 months (mean, 10.3 months). The operation time, intraoperative blood loss, length of incision, postoperative drainage volume, and unloaded activity time in SuperPATH group were significantly superior to those in PSA group (P<0.05). The Harris score at 2 weeks and 1 month after operation were significantly higher in SuperPATH group than that in PSA group (P<0.05). But there was no significant difference in the Harris scores at 3 and 6 months after operation between 2 groups (P>0.05). At last follow-up, the SF-36 scores were higher in SuperPATH group than those in PSA group (P<0.05). Postoperative X-ray films showed the joint prosthesis was in good position. Conclusion THA via SuperPATH approach has the advantages of minimal invasion, safe, and rapid recovery, which is better than THA via posterolateral approach.

Citation： YUAN Hongmou, ZHU Jiajun, SUN Zhenguo, ZHANG Zhiyu. Comparison of effectiveness between SuperPATH approach and posterolateral approach in total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(1): 14-19. doi: 10.7507/1002-1892.201707121 Copy

1.	孙欣, 曾荣, 胡资兵, 等. 空心螺钉内固定治疗股骨颈骨折术后股骨头坏死的影响因素分析. 中华创伤骨科杂志, 2012, 14(6): 477-479.
2.	秦啸龙, 张先龙, 蒋垚, 等. 股外侧皮神经的手术安全区与前侧入路微创全髋关节置换术切口的选择. 中华关节外科杂志 (电子版), 2008, 2(3): 21-23.
3.	de Steiger RN, Lorimer M, Solomon M, et al. What is the learning curve for the anterior approach for total hip arthroplasty? Clin Orthop Relat Res, 2015, 473(12): 3860-3866.
4.	Christensen CP, Karthikeyan T, Jacobs CA, et al. Greater prevalence of wound complications requiring reoperation with direct anterior approach total hip arthroplasty. J Arthroplasty, 2014, 29(9): 1839-1841.
5.	白波, 陈玉书. 中国微创全髋人工关节置换术的现状和将来. 中华关节外科杂志 (电子版), 2015, 9(6): 707-710.
6.	Cardenas-Nylander C, Bellotti V, Astarita E, et al. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Hip Int, 2016, 26 Suppl 1: 34-37.
7.	Arora KS, Khan N, Abboudi H, et al. Learning curves for cardiothoracic and vascular surgical procedures-a systematic review. Postgrad Med, 2015, 127(2): 202-214.
8.	Bozic KJ, Ward L, Vail TP, et al. Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction. Clin Orthop Relat Res, 2014, 472(1): 188-193.
9.	Capuano N, Del Bunon A, Maffulli N. Tissue preserving total hip arthroplasty using superior capsulotomy. Oper Orthop Traumatol, 2015, 27(4): 334-341.
10.	Rasuli KJ, Gofton W. Percutaneously assisted total hip (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomess. Ann Transl Med, 2015, 3(13): 179.
11.	Gofton W, Chow J, Olsen KD, et al. Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneous-assisted total hip surgical technique. Int Orthop, 2015, 39(5): 847-851.
12.	Della Torre PK, Fitch DA, Chow JC, et al. Supercapsular percutaneously-assisted total hip arthroplasty: radiographic outcomes and surgical technique. Ann Transl Med, 2015, 3(13): 180.
13.	Mehrotra A, Sloss EM, Hussey PS, et al. Evaluation of centers of excellence program for knee and hip replacement. Med Care, 2013, 51(1): 28-36.
14.	Gofton W, Fitch DA. In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement. Int Orthop, 2016, 40(3): 481-485.
15.	Bodrogi AW, Sciortino R, Fitch DA, et al. Use of the supercapsular percutaneously assisted total hip approach for femoral neck fractures: surgical technique and case series. J Orthop Surg Res, 2016, 11(1): 113.
16.	Itokawa T, Nakashima Y, Yamamoto T, et al. Late dislocation is associated with recurrence after total hip arthroplasty. Int Orthop, 2013, 37(8): 1457-1463.
17.	Yoshihara H, Yoneoka D. National trends in the utilization of blood transfusions in total hip and knee arthroplasty. J Arthroplast, 2014, 29(10): 1932-1937.
18.	Tuttle JR, Ritterman SA, Cassidy DB, et al. Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty. J Arthroplast, 2014, 29(8): 1512-1515.

1. 孙欣, 曾荣, 胡资兵, 等. 空心螺钉内固定治疗股骨颈骨折术后股骨头坏死的影响因素分析. 中华创伤骨科杂志, 2012, 14(6): 477-479.
2. 秦啸龙, 张先龙, 蒋垚, 等. 股外侧皮神经的手术安全区与前侧入路微创全髋关节置换术切口的选择. 中华关节外科杂志 (电子版), 2008, 2(3): 21-23.
3. de Steiger RN, Lorimer M, Solomon M, et al. What is the learning curve for the anterior approach for total hip arthroplasty? Clin Orthop Relat Res, 2015, 473(12): 3860-3866.
4. Christensen CP, Karthikeyan T, Jacobs CA, et al. Greater prevalence of wound complications requiring reoperation with direct anterior approach total hip arthroplasty. J Arthroplasty, 2014, 29(9): 1839-1841.
5. 白波, 陈玉书. 中国微创全髋人工关节置换术的现状和将来. 中华关节外科杂志 (电子版), 2015, 9(6): 707-710.
6. Cardenas-Nylander C, Bellotti V, Astarita E, et al. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Hip Int, 2016, 26 Suppl 1: 34-37.
7. Arora KS, Khan N, Abboudi H, et al. Learning curves for cardiothoracic and vascular surgical procedures-a systematic review. Postgrad Med, 2015, 127(2): 202-214.
8. Bozic KJ, Ward L, Vail TP, et al. Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction. Clin Orthop Relat Res, 2014, 472(1): 188-193.
9. Capuano N, Del Bunon A, Maffulli N. Tissue preserving total hip arthroplasty using superior capsulotomy. Oper Orthop Traumatol, 2015, 27(4): 334-341.
10. Rasuli KJ, Gofton W. Percutaneously assisted total hip (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomess. Ann Transl Med, 2015, 3(13): 179.
11. Gofton W, Chow J, Olsen KD, et al. Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneous-assisted total hip surgical technique. Int Orthop, 2015, 39(5): 847-851.
12. Della Torre PK, Fitch DA, Chow JC, et al. Supercapsular percutaneously-assisted total hip arthroplasty: radiographic outcomes and surgical technique. Ann Transl Med, 2015, 3(13): 180.
13. Mehrotra A, Sloss EM, Hussey PS, et al. Evaluation of centers of excellence program for knee and hip replacement. Med Care, 2013, 51(1): 28-36.
14. Gofton W, Fitch DA. In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement. Int Orthop, 2016, 40(3): 481-485.
15. Bodrogi AW, Sciortino R, Fitch DA, et al. Use of the supercapsular percutaneously assisted total hip approach for femoral neck fractures: surgical technique and case series. J Orthop Surg Res, 2016, 11(1): 113.
16. Itokawa T, Nakashima Y, Yamamoto T, et al. Late dislocation is associated with recurrence after total hip arthroplasty. Int Orthop, 2013, 37(8): 1457-1463.
17. Yoshihara H, Yoneoka D. National trends in the utilization of blood transfusions in total hip and knee arthroplasty. J Arthroplast, 2014, 29(10): 1932-1937.
18. Tuttle JR, Ritterman SA, Cassidy DB, et al. Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty. J Arthroplast, 2014, 29(8): 1512-1515.

Chinese Journal of Reparative and Reconstructive Surgery

Comparison of effectiveness between SuperPATH approach and posterolateral approach in total hip arthroplasty

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