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Faculty of Medical Sciences

Transition from straight lateral to direct anterior approach in total hip arthroplasty: a retrospective single-center study.

Visser, L.C.E. (Coen) (2022) Transition from straight lateral to direct anterior approach in total hip arthroplasty: a retrospective single-center study. thesis, Medicine.

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Abstract

Introduction: Total hip arthroplasty is a successful treatment for end-stage osteoarthritis. Recently, the direct anterior approach is getting increasingly more popular due to the musclesparing approach. This allows a reduction of postoperative pain and is associated with faster rehabilitation. The aim of our retrospective cohort study was to examine whether the shortterm benefits of the DA approach outweigh the disadvantages of the learning curve. Method: In this retrospective cohort study we investigated a total of 2133 total hip arthroplasties from 2015-2020, divided over three periods: pre-transition period, transition period and post-transition period. In the pre-transition period, the straight lateral approach was used, in the transition period both the straight lateral approach and direct anterior approach were used whereas during the post-transition period only the direct anterior approach was used. The HOOS-PS score was recorded before and one year after surgery. Complications, blood loss, duration of surgery and length of stay were analysed. Results: The largest improvement in HOOS-PS score was for the direct anterior approach in the transition period (39,22 ± 17,92) and in the post-transition period (35,71 ± 0,96). Complication rates between periods stayed the same between groups. Duration of surgery and length of stay improved statistically significantly between periods. Blood loss stayed did not differ significantly between periods. Conclusion: The learning curve associated with the transition from the SL approach to the DA approach does not have a negative effect on applying a THA. Once the following condition is met: an experienced surgeon supervises the first surgeries of the learning curve. The advantages of the DA approach can be implemented without an increase in complications

Item Type: Thesis (UNSPECIFIED)
Supervisor name: Bolink, S.A.A.N.
Faculty: Medical Sciences
Date Deposited: 21 Jul 2023 11:21
Last Modified: 21 Jul 2023 11:21
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/3594

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