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

Content Provider	Springer Nature : BioMed Central
Author	Hürlimann, Maya Schiapparelli, Filippo-Franco Rotigliano, Niccolo Testa, Enrique Amsler, Felix Hirschmann, Michael T.
Abstract	Background Heterotopic 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. Methods This 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). Results Overall, 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. Conclusions The 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.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-017-1391-x.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-017-1391-x
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2017-01-21
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Heterotopic ossification Anterolateral minimal invasive approach Watson-Jones Periarticular ossification Total hip arthroplasty THA Transgluteal Bauer Direct anterior approach
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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