No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry
Background and purpose: The direct superior approach (DSA) is a modification of the posterolateral approach (PLA) for total hip arthroplasty (THA). Patient-reported outcome measures (PROMs) of the DSA have not been investigated previously using nationwide data. Our aim was to assess PROMs after THA...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2023-10-01
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| Series: | Acta Orthopaedica |
| Online Access: | https://actaorthop.org/actao/article/view/23729 |
| _version_ | 1797644327988494336 |
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| author | Bart van Dooren Rinne M Peters Liza N van Steenbergen Richard A J Post Harmen B Ettema Stefan B T Bolder B Willem Schreurs Wierd P Zijlstra |
| author_facet | Bart van Dooren Rinne M Peters Liza N van Steenbergen Richard A J Post Harmen B Ettema Stefan B T Bolder B Willem Schreurs Wierd P Zijlstra |
| author_sort | Bart van Dooren |
| collection | DOAJ |
| description |
Background and purpose: The direct superior approach (DSA) is a modification of the posterolateral approach (PLA) for total hip arthroplasty (THA). Patient-reported outcome measures (PROMs) of the DSA have not been investigated previously using nationwide data. Our aim was to assess PROMs after THA using the DSA compared with the PLA and, secondarily, with the anterior approach (DAA).
Patients and methods: In this population-based cohort study we included 37,976 primary THAs performed between 2014 and 2020 (PLA: n = 22,616; DAA: n = 15,017; DSA: n = 343) using Dutch Arthroplasty Registry data. PROMs (NRS pain, EQ-5D, HOOS-PS, and OHS) were measured preoperatively, and at 3 and 12 months postoperatively. Repeated measurements were analyzed using mixed-effects models, adjusted for confounders, to investigate the association between surgical approach and PROMs over time.
Results: From baseline to 3 and 12 months, improvements for NRS pain scores, EQ-5D, and OHS were comparable for the DSA compared with the PLA or DAA. No difference was found in HOOS-PS improvement 3 months postoperatively between DSA and PLA (–0.2, 95% confidence interval [CI] –2.4 to 1.9) and between DSA and DAA (–1.7, CI –3.9 to 0.5). At 12 months postoperatively, patients in the DSA group had improved –2.8 points (CI –4.9 to –0.6) more in HOOS-PS compared with the DAA, but not with the PLA group (–1.0, CI –3.2 to 1.1).
Conclusion: Our study showed no clinically meaningful differences between the DSA and either PLA or DAA.
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| first_indexed | 2024-03-11T14:28:56Z |
| format | Article |
| id | doaj.art-313bd2e25dfd40aa9b10126c56000405 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-03-11T14:28:56Z |
| publishDate | 2023-10-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-313bd2e25dfd40aa9b10126c560004052023-10-31T10:31:53ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822023-10-019410.2340/17453674.2023.23729No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty RegistryBart van Dooren0Rinne M Peters1Liza N van Steenbergen2Richard A J Post3Harmen B Ettema4Stefan B T Bolder5B Willem Schreurs6Wierd P Zijlstra7Department of Orthopaedics, Medical Center Leeuwarden, Leeuwarden; Department of Orthopaedics, University Medical Center Groningen, GroningenDepartment of Orthopaedics, Medical Center Leeuwarden, Leeuwarden; Department of Orthopaedics, Martini Hospital, GroningenDutch Arthroplasty Registry (LROI), ‘s HertogenboschDutch Arthroplasty Registry (LROI), ‘s Hertogenbosch; Department of Mathematics and Computer Science, Eindhoven University of Technology, EindhovenDepartment of Orthopaedics, Isala, ZwolleDepartment of Orthopaedics, Amphia Hospital, BredaDutch Arthroplasty Registry (LROI), ‘s Hertogenbosch; Department of Orthopaedics, Radboud University Medical Center , Nijmegen, the NetherlandsDepartment of Orthopaedics, Medical Center Leeuwarden, Leeuwarden Background and purpose: The direct superior approach (DSA) is a modification of the posterolateral approach (PLA) for total hip arthroplasty (THA). Patient-reported outcome measures (PROMs) of the DSA have not been investigated previously using nationwide data. Our aim was to assess PROMs after THA using the DSA compared with the PLA and, secondarily, with the anterior approach (DAA). Patients and methods: In this population-based cohort study we included 37,976 primary THAs performed between 2014 and 2020 (PLA: n = 22,616; DAA: n = 15,017; DSA: n = 343) using Dutch Arthroplasty Registry data. PROMs (NRS pain, EQ-5D, HOOS-PS, and OHS) were measured preoperatively, and at 3 and 12 months postoperatively. Repeated measurements were analyzed using mixed-effects models, adjusted for confounders, to investigate the association between surgical approach and PROMs over time. Results: From baseline to 3 and 12 months, improvements for NRS pain scores, EQ-5D, and OHS were comparable for the DSA compared with the PLA or DAA. No difference was found in HOOS-PS improvement 3 months postoperatively between DSA and PLA (–0.2, 95% confidence interval [CI] –2.4 to 1.9) and between DSA and DAA (–1.7, CI –3.9 to 0.5). At 12 months postoperatively, patients in the DSA group had improved –2.8 points (CI –4.9 to –0.6) more in HOOS-PS compared with the DAA, but not with the PLA group (–1.0, CI –3.2 to 1.1). Conclusion: Our study showed no clinically meaningful differences between the DSA and either PLA or DAA. https://actaorthop.org/actao/article/view/23729 |
| spellingShingle | Bart van Dooren Rinne M Peters Liza N van Steenbergen Richard A J Post Harmen B Ettema Stefan B T Bolder B Willem Schreurs Wierd P Zijlstra No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry Acta Orthopaedica |
| title | No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry |
| title_full | No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry |
| title_fullStr | No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry |
| title_full_unstemmed | No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry |
| title_short | No clinically relevant difference in patient-reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty: analysis of 37,976 primary hip arthroplasties in the Dutch Arthroplasty Registry |
| title_sort | no clinically relevant difference in patient reported outcomes between the direct superior approach and the posterolateral or anterior approach for primary total hip arthroplasty analysis of 37 976 primary hip arthroplasties in the dutch arthroplasty registry |
| url | https://actaorthop.org/actao/article/view/23729 |
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