Factors Influencing the Outcomes of Minimally Invasive Total Hip Arthroplasty: a Systematic Review

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2022 May 18

PMID 35585545

Authors

Filippo Migliorini

Andrea Pintore

Joerg Eschweiler

Francesco Oliva

Frank Hildebrand

Nicola Maffulli

Affiliations

Soon will be listed here.

Abstract

Introduction: The present systematic review investigated possible factors which may influence the surgical outcome of minimally invasive surgery for total hip arthroplasty (MIS THA).

Methods: In January 2022, the Embase, Google Scholar, PubMed, and Scopus databases were accessed. All the clinical trials investigating the clinical outcome of MIS THA were considered.

Results: Data from 9486 procedures were collected. Older age was moderately associated with greater Visual Analogue Scale (VAS) (P = 0.02) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (P = 0.009) at last follow-up, and shorter surgical duration (P = 0.01). Greater body mass index (BMI) at baseline was moderately associated with greater cup anteversion (P = 0.0009), Oxford Hip Score (OHS) at last follow-up (P = 0.04), longer surgical duration (P = 0.04), increased leg length discrepancy (P = 0.02), and greater rate of infection (P = 0.04). Greater VAS at baseline was weakly associated with greater VAS at last follow-up (P < 0.0001), total estimated blood lost (P = 0.01), and lower value of Harris Hip Score (HHS) (P = 0.0005). Greater OHS at baseline was associated with greater post-operative VAS (P = 0.01). Greater WOMAC at baseline was associated with lower cup anteversion (P = 0.009) and greater VAS (P = 0.02). Greater HHS at baseline was associated with shorter hospitalisation (P = 0.001).

Conclusion: Older age and greater BMI may represent negative prognostic factors for MIS THA. The clinical outcome is strongly influenced by the preoperative status of patients.

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References

Laffosse J, Chiron P, Tricoire J, Giordano G, Molinier F, Puget J . [Prospective and comparative study of minimally invasive posterior approach versus standard posterior approach in total hip replacement]. Rev Chir Orthop Reparatrice Appar Mot. 2007; 93(3):228-37. DOI: 10.1016/s0035-1040(07)90244-5. View

Iorio R, Viglietta E, Mazza D, Iannotti F, Nicolosi I, Carrozzo A . Do serum markers correlate with invasiveness of the procedure in THA? A prospective randomized study comparing direct anterior and lateral approaches. Orthop Traumatol Surg Res. 2021; 107(8):102937. DOI: 10.1016/j.otsr.2021.102937. View

Perkins F, Kehlet H . Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000; 93(4):1123-33. DOI: 10.1097/00000542-200010000-00038. View

Migliorini F, Eschweiler J, Trivellas A, Rath B, Driessen A, Tingart M . Implant positioning among the surgical approaches for total hip arthroplasty: a Bayesian network meta-analysis. Arch Orthop Trauma Surg. 2020; 140(8):1115-1124. DOI: 10.1007/s00402-020-03448-w. View

Issa K, Harwin S, Malkani A, Bonutti P, Scillia A, Mont M . Bariatric Orthopaedics: Total Hip Arthroplasty in Super-Obese Patients (Those with a BMI of ≥50 kg/m2). J Bone Joint Surg Am. 2016; 98(3):180-5. DOI: 10.2106/JBJS.O.00474. View

Howell J, Masri B, Duncan C . Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. Orthop Clin North Am. 2004; 35(2):153-62. DOI: 10.1016/S0030-5898(03)00137-8. View

Alecci V, Valente M, Crucil M, Minerva M, Pellegrino C, Sabbadini D . Comparison of primary total hip replacements performed with a direct anterior approach versus the standard lateral approach: perioperative findings. J Orthop Traumatol. 2011; 12(3):123-9. PMC: 3163771. DOI: 10.1007/s10195-011-0144-0. View

Leuchte S, Luchs A, Wohlrab D . [Measurement of ground reaction forces after total hip arthroplasty using different surgical approaches]. Z Orthop Ihre Grenzgeb. 2007; 145(1):74-80. DOI: 10.1055/s-2007-960511. View

Nilsdotter A, Lohmander L . Age and waiting time as predictors of outcome after total hip replacement for osteoarthritis. Rheumatology (Oxford). 2002; 41(11):1261-7. DOI: 10.1093/rheumatology/41.11.1261. View

10.

Khan R, Maor D, Hofmann M, Haebich S . A comparison of a less invasive piriformis-sparing approach versus the standard posterior approach to the hip: A randomised controlled trial. J Bone Joint Surg Br. 2012; 94(1):43-50. DOI: 10.1302/0301-620X.94B1.27001. View

11.

Engdal M, Foss O, Taraldsen K, Husby V, Winther S . Daily Physical Activity in Total Hip Arthroplasty Patients Undergoing Different Surgical Approaches: A Cohort Study. Am J Phys Med Rehabil. 2017; 96(7):473-478. DOI: 10.1097/PHM.0000000000000657. View

12.

Berger R, Jacobs J, Meneghini R, Della Valle C, Paprosky W, Rosenberg A . Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2004; (429):239-47. DOI: 10.1097/01.blo.0000150127.80647.80. View

13.

Lin D, Jan M, Liu T, Lin Y, Hou S . Effects of anterolateral minimally invasive surgery in total hip arthroplasty on hip muscle strength, walking speed, and functional score. J Arthroplasty. 2007; 22(8):1187-92. DOI: 10.1016/j.arth.2006.11.011. View

14.

Kim Y . Comparison of primary total hip arthroplasties performed with a minimally invasive technique or a standard technique: a prospective and randomized study. J Arthroplasty. 2006; 21(8):1092-8. DOI: 10.1016/j.arth.2006.01.015. View

15.

Sendtner E, Borowiak K, Schuster T, Woerner M, Grifka J, Renkawitz T . Tackling the learning curve: comparison between the anterior, minimally invasive (Micro-hip®) and the lateral, transgluteal (Bauer) approach for primary total hip replacement. Arch Orthop Trauma Surg. 2010; 131(5):597-602. DOI: 10.1007/s00402-010-1174-4. View

16.

Dorr L, Maheshwari A, Long W, Wan Z, Sirianni L . Early pain relief and function after posterior minimally invasive and conventional total hip arthroplasty. A prospective, randomized, blinded study. J Bone Joint Surg Am. 2007; 89(6):1153-60. DOI: 10.2106/JBJS.F.00940. View

17.

Brander V, Malhotra S, Jet J, Heinemann A, Stulberg S . Outcome of hip and knee arthroplasty in persons aged 80 years and older. Clin Orthop Relat Res. 1998; (345):67-78. View

18.

Basbaum A . Spinal mechanisms of acute and persistent pain. Reg Anesth Pain Med. 1999; 24(1):59-67. DOI: 10.1016/s1098-7339(99)90167-0. View

19.

Pierrepont J, Marel E, Bare J, Walter L, Stambouzou C, Solomon M . Variation in femoral anteversion in patients requiring total hip replacement. Hip Int. 2019; 30(3):281-287. DOI: 10.1177/1120700019848088. View

20.

Muller M, Tohtz S, Dewey M, Springer I, Perka C . [Muscle trauma in primary total hip arthroplasty depending on age, BMI, and surgical approach: minimally invasive anterolateral versus modified direct lateral approach]. Orthopade. 2011; 40(3):217-23. DOI: 10.1007/s00132-010-1730-1. View