Influence of surgical approach on heterotopic ossification after total hip arthroplasty – is minimal invasive better? A case control study

BMC Musculoskeletal Disorders

Research Article

Felix Amsler¹  Enrique Testa²  Niccolo Rotigliano³  Michael T. Hirschmann³  Maya Hürlimann³  Filippo-Franco Schiapparelli³ 

[1] Amsler Consulting, CH-4059, Basel, Switzerland;Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101, Bruderholz, Switzerland;Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), CH-4101, Bruderholz, Switzerland;University of Basel, Basel, Switzerland;

关键词: Heterotopic ossification;    Anterolateral minimal invasive approach;    Watson-Jones;    Periarticular ossification;    Total hip arthroplasty;    THA;    Transgluteal Bauer;    Direct anterior approach;   

DOI  :  10.1186/s12891-017-1391-x

 received in 2016-07-05, accepted in 2017-01-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHeterotopic ossification (HO) is a well-known complication after total hip arthroplasty (THA).Recently, the trend is to operate THA minimally invasive being less traumatic than standard approaches and promising a faster return to activity. The purpose of the study was to investigate if minimal invasive surgery (MIS), leads also to less HO after THA.MethodsThis retrospective study included 134 consecutive patients undergoing THA. In 42 (31.3%) patients a standard modified anterolateral (STD-Watson-Jones), in 28 (20.9%) patients a standard transgluteal Bauer approach (STD-Bauer), in 39 (29.1%) a MIS direct anterior approach (AMIS) and in 25 (18.7%) patients a MIS anterolateral (MIS-AL) approach was used. Standard preoperative anterior-posterior and lateral radiographs were assessed for occurrence of HO. HO was classified according to Brooker. In addition, short- and long-term adverse events were noted. Data was statistically analyzed using Chi-square tests, analysis of variance, multivariate data analysis and Pearson’s correlation (p < 0.05).ResultsOverall, HO was found in 38 caucasian patients (28.4%) after THA. The STD-Watson-Jones group showed the highest HO rate (45.2% n = 19) with a significant difference to the AMIS (23.1% n = 9) and STD-Bauer approach (14.3% n = 4). No statistical difference was found to the MIS-AL approach (24.0% n = 6). Postoperative complications did not differ significantly except for a higher incidence of Trendelenburg`s sign in STD-Bauer.ConclusionsThe rate and degree of HO after THA were significantly different with regards to the surgical approach. The standard modified anterolateral approach resulted in the highest HO rate, however, MIS approaches showed higher HO rates than the STD-Bauer.

【 授权许可】

CC BY   
© The Author(s). 2017