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Muscle recovery after total hip arthroplasty: prospective MRI comparison of anterior and posterior approaches.
- Source :
-
Hip International . Jul2023, Vol. 33 Issue 4, p611-619. 9p. - Publication Year :
- 2023
-
Abstract
- Introduction: The direct anterior approach (DAA) and the posterior approach (PA) are 2 common total hip arthroplasty (THA) exposures. This prospective study quantitatively compared changes in periarticular muscle volume after DAA and PA THA. Materials: 19 patients undergoing THA were recruited prospectively from the practices of 3 fellowship-trained hip surgeons. Each surgeon performed a single approach, DAA or PA. Enrolled patients underwent a preoperative MRI of the affected hip and two subsequent postoperative MRIs at around 6 weeks and 6 months after surgery. Clinical evaluations were done by Harris Hip Score at each follow-up interval. Results: MRIs or 10 DAA and 9 PA patients were analysed. Groups did not differ significantly with regard to BMI, age, or preoperative muscle volume. 1 DAA patient suffered a periprosthetic fracture and was excluded from the study. DAA hips showed significant atrophy in the obturator internus (−37.3%) muscle at early follow-up, with persistent atrophy of this muscle at the final follow-up. PA hips showed significant atrophy in the obturator internus (−46.8%) and externus (−16.0%), piriformis (−8.12%), and quadratus femoris muscles (−13.1%) at early follow-up, with persistent atrophy of these muscles at final follow-up. Loss of anterior capsular integrity was present at final follow-up in 2/10 DAA hips while loss of posterior capsular integrity was present in 5/9 PA hips. There was no difference in clinical outcomes. Discussion: This study demonstrates that DAA showed less persistent muscular atrophy than PA. Regardless of surgical approach, a muscle whose tendon is detached from its insertion is likely to demonstrate persistent atrophy 6 months following THA. Although the study was not powered to compare clinical outcomes, it should be noted that no significant difference in patient outcomes was observed. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 11207000
- Volume :
- 33
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Hip International
- Publication Type :
- Academic Journal
- Accession number :
- 164871591
- Full Text :
- https://doi.org/10.1177/11207000221114456