Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty
Abstract Background Total hip arthroplasty (THA) performed using the direct anterior approach (DAA) has demonstrated favourable early-, mid-, and long-term outcomes. However, the traditional femoral release technique remains technically demanding and is associated with challenges and a heightened ri...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-023-04334-y |
| _version_ | 1827709400293310464 |
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| author | Hua-zhang Xiong Li-dan Yang Gang Bao Jia-chen Peng Zhi-hong Liu |
| author_facet | Hua-zhang Xiong Li-dan Yang Gang Bao Jia-chen Peng Zhi-hong Liu |
| author_sort | Hua-zhang Xiong |
| collection | DOAJ |
| description | Abstract Background Total hip arthroplasty (THA) performed using the direct anterior approach (DAA) has demonstrated favourable early-, mid-, and long-term outcomes. However, the traditional femoral release technique remains technically demanding and is associated with challenges and a heightened risk of complications. This study aimed to compare the clinical outcomes of patients who underwent THA with DAA performed using either the femoral-release-first (FRF) or the traditional approach (TA) strategy. Methods A retrospective analysis of demographics, clinical and radiological outcomes, and occurrence of complications was performed using data from 106 patients between 2018 and 2019. The patients were categorised into two groups: FRF (44 hips) and TA (69 hips). Results The FRF group showed a reduced operative time, haemoglobin (Hb) drop, postoperative hospital stay, and more optimal acetabular cup anteversion angles. Furthermore, during the first 2 months postoperatively, the FRF group demonstrated superior visual analogue scale, Harris Hip, and Oxford Hip scores. In the TA group, two hips experienced greater trochanter fractures, and one experienced delayed incision healing. Conclusions Compared with the TA, employing the FRF strategy during THA with DAA resulted in improved outcomes within the first 2 months postoperatively and comparable functional recovery beyond this period. The FRF method exhibited advantages such as favourable acetabular exposure and alignment and a reduced risk of complications. Therefore, the FRF strategy may be a favourable option. |
| first_indexed | 2024-03-10T17:21:27Z |
| format | Article |
| id | doaj.art-70785ef4da534e4f98f5d10af687476a |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-10T17:21:27Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-70785ef4da534e4f98f5d10af687476a2023-11-20T10:20:09ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-11-0118111110.1186/s13018-023-04334-yImproved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplastyHua-zhang Xiong0Li-dan Yang1Gang Bao2Jia-chen Peng3Zhi-hong Liu4Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Orthopedic Surgery, People’s Hospital of Yinjiang Tujia and Miao Autonomous CountyDepartment of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Total hip arthroplasty (THA) performed using the direct anterior approach (DAA) has demonstrated favourable early-, mid-, and long-term outcomes. However, the traditional femoral release technique remains technically demanding and is associated with challenges and a heightened risk of complications. This study aimed to compare the clinical outcomes of patients who underwent THA with DAA performed using either the femoral-release-first (FRF) or the traditional approach (TA) strategy. Methods A retrospective analysis of demographics, clinical and radiological outcomes, and occurrence of complications was performed using data from 106 patients between 2018 and 2019. The patients were categorised into two groups: FRF (44 hips) and TA (69 hips). Results The FRF group showed a reduced operative time, haemoglobin (Hb) drop, postoperative hospital stay, and more optimal acetabular cup anteversion angles. Furthermore, during the first 2 months postoperatively, the FRF group demonstrated superior visual analogue scale, Harris Hip, and Oxford Hip scores. In the TA group, two hips experienced greater trochanter fractures, and one experienced delayed incision healing. Conclusions Compared with the TA, employing the FRF strategy during THA with DAA resulted in improved outcomes within the first 2 months postoperatively and comparable functional recovery beyond this period. The FRF method exhibited advantages such as favourable acetabular exposure and alignment and a reduced risk of complications. Therefore, the FRF strategy may be a favourable option.https://doi.org/10.1186/s13018-023-04334-yDirect anterior approachTotal hip arthroplastyComparisonTraditional approachFemoral-release-first |
| spellingShingle | Hua-zhang Xiong Li-dan Yang Gang Bao Jia-chen Peng Zhi-hong Liu Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty Journal of Orthopaedic Surgery and Research Direct anterior approach Total hip arthroplasty Comparison Traditional approach Femoral-release-first |
| title | Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty |
| title_full | Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty |
| title_fullStr | Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty |
| title_full_unstemmed | Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty |
| title_short | Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty |
| title_sort | improved surgical exposure and early clinical outcomes using a femoral release first technique in direct anterior approach during total hip arthroplasty |
| topic | Direct anterior approach Total hip arthroplasty Comparison Traditional approach Femoral-release-first |
| url | https://doi.org/10.1186/s13018-023-04334-y |
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