Influence of surgical approach on component positioning in primary total hip arthroplasty

BMC Musculoskeletal Disorders

Christian Merle¹  Tobias Gotterbarm¹  Matthias Königshausen⁴  Peter R. Aldinger²  Dominik Parsch³  Jochen Heiland¹  Jeanette Kolb¹  Marcus R. Streit¹  Moritz M. Innmann¹ 

[1] Department of Orthopaedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, Heidelberg, 69118, Germany;Department of Orthopaedic and Trauma Surgery, Paulinenhilfe, Diakonieklinikum, Rosenbergstrasse 38, Stuttgart, 70192, Germany;Department of Orthopaedic and Trauma Surgery, Karl-Olga-Krankenhaus, Hackstraße 61, Stuttgart, 70190, Germany;Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany

关键词: Hip arthroplasty;    Hip replacement;    Implant positioning;    Lateral approach;    Anterolateral approach;    Minimal invasive approach;   

Others  :  1227704
DOI  :  10.1186/s12891-015-0623-1

 received in 2015-02-11, accepted in 2015-07-08,  发布年份 2015

【 摘 要 】

Background

Minimal invasive surgery (MIS) has gained growing popularity in total hip arthroplasty (THA) but concerns exist regarding component malpositioning. The aim of the present study was to evaluate femoral and acetabular component positioning in primary cementless THA comparing a lateral to a MIS anterolateral approach.

Methods

We evaluated 6 week postoperative radiographs of 52 hips with a minimal invasive anterolateral approach compared to 54 hips with a standard lateral approach. All hips had received the same type of implant for primary cementless unilateral THA and had a healthy hip contralaterally.

Results

Hip offset was equally restored comparing both approaches. No influence of the approach was observed with regard to reconstruction of acetabular offset, femoral offset, vertical placement of the center of rotation, stem alignment and leg length discrepancy. However, with the MIS approach, a significantly higher percentage of cups (38.5 %) was malpositioned compared to the standard approach (16.7 %) (p = 0.022).

Conclusions

The MIS anterolateral approach allows for comparable reconstruction of stem position, offset and center of rotation compared to the lateral approach. However, surgeons must be aware of a higher risk of cup malpositioning for inclination and anteversion using the MIS anterolateral approach.

【 授权许可】

   
2015 Innmann et al.

【 图 表 】

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