Minimally invasive surgery supercapsular percutaneously-assisted total hip (SuperPath) arthroplasty
Applicability to mildly dysplastic osteoarthritis and early recovery of lower limb function
Keywords:
total hip arthroplasty, SuperPath approach, early recovery, minimally invasive surgery, percutaneous assisted total hipAbstract
Background and aim: The benefits of minimally invasive surgical techniques in total hip arthroplasty (THA) are well known, but concerns about applying SuperPATH in patients with secondary OA of acetabular dysplasia do not have been reported. We aim to evaluate whether SuperPATH is applicable to secondary OA, furthermore, to quantify the recovery of lower extremity function.
Methods: 30 patients with secondary OA admitted for THA applying SuperPATH were investigated. Clinical Japanese Orthopaedic Association (JOA) Score and radiographical evaluation were performed. Following was examined pre- and early post-operatively; pain level, blood tests, TUG and 10-M walking time for lower limb recovery.
Results: Preoperative radiographic measurements revealed an average Sharp angle of 46.2 ± 2.8 degrees and CE angle of 19.4 ± 7.3 degrees. 29 THAs had Crowe Type I and 1 THA had Crowe Type II. JOA score improved from 48.8 preoperatively to 91.5 at 2 months postoperatively. The perioperative pain assessment (VAS) averaged 7.0±1.5 preoperatively, 4.6±2.6 on the first postoperative day, then decreased gradually to 1.2±1.4 at 2 weeks.
Blood data showed that creatine kinase, myoglobin, and CRP were significantly elevated on the day after surgery, but they normalized at 2 weeks postoperatively. Both TUG and 10M walking time showed slightly higher values at 1 week postoperatively compared to preoperatively but recovered to the same level as preoperatively at 2 weeks after surgery.
Conclusions: Our data suggests that SuperPATH approach to THA for dysplastic OA was applicable to mildly dysplastic OA and achieved an early recovery of lower limb function.
References
Murphy SB. Tissue-preserving, minimally invasive total hip arthroplasty using a superior capsulotomy. In: Hozack W, editor. Minimally invasive total hip and knee arthroplasty. Heidelberg: Springer-Verlag. 2004 :101–107.
Murphy SB. Total hip arthroplasty using the superior capsulotomy technique. Instr Course Lect. 2013 ;62: 245-250.
Penenberg BL, Bolling WS, Riley M. Percutaneously assisted total hip arthroplasty (PATH): a preliminary report. J Bone Joint Surg Am 2008 ;90(Suppl 4): 209-220
Chow J, Penenberg BL and Murphy SB. Modified micro-superior percutaneously-assisted total hip: early experiences & case reports. Curr Rev Musculoskeletal Med 2011; 4: 146–150.
Gofton W et al. Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique. Int Orthop 2015; 39: 847-851.
Ramadanov N et al. Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2020; 17:15: 420.
Tottas S et al. Supercapsular Percutaneously Assisted total hip arthroplasty versus lateral approach in Total Hip Replacement. A prospective comparative study. J Orthop 2020; 16: 21: 406-415.
Crowe JF, Mani VJ and Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 1979; 61: 15-23.
Zahiri CA et al. Assessing activity in joint replacement patients. J Arthroplasty 1998; 13: 890–895.
Hasegawa Y et al. The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia. Arch Orthop Trauma Surg 1992; 111: 187–191.
Podsiadlo D and Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148
Peters DM, Fritz SL and Krotish DE: Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther 2013; 36: 24–30.
Sharp IK. Acetabular dysplasia: the acetabular angle. J Bone Joint Surg Br 1961; 43-B: 268-272.
Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint: with special reference to the complication of osteoarthritis. Acta Chir Scand 1939; 83 (Suppl 58): 28-38.
Engh CA, Massin P and Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 1990; 257: 107-28.
McPherson EJ et al. Hydroxyapatite-coated proximal ingrowth femoral stems. A matched pair control study. Clin Orthop Relat Res 1995; 315: 223-30.
Carlos B et al. Comparison of short-term outcomes between minimal invasive SuperPATH approach and conventional posterior approach in total hip arthroplasty: a randomized controlled trial. International Journal of Research in Orthopaedics 2021; 7: 431-437.
Li X et al. Comparison of total hip arthroplasty with minimally invasive SuperPath approach vs. conventional posterolateral approach in elderly patients: A one-year follow-up randomized controlled research. Asian J Surg 2021; 44: 531-536.
Russell G et al. The Relationship Between Skeletal Muscle Serum Markers and Primary THA. A Pilot Study. Clin Orthop Relat Res 2009; 467: 1747-1752.
Zhang, B., Simple gait analysis after total hip arthroplasty with SuperPATH approach and traditional Hardinge approach. Qingdao University 2018
Dou XF et al. Application of rapid rehabilitation intervention in SuperPATH minimally invasive total hiparthroplasty. Nursing and Rehabilitation 2017
Fink B et al. Comparison of a minimally invasive posteriorapproach and the standard posterior approach for total hip arthroplasty A prospective and comparative study. Journal of Orthopaedic Surgery and Research 2010; 5: 46.
Pengfei L et al. Assessment of the Learning Curve of Supercapsular Percutaneously Assisted Total Hip Arthroplasty in an Asian Population. BioMed Research International 2020
Ge, Y., et al. A systematic review and meta-analysis of SuperPATH approach in total hip arthroplasty. Journal of Integrative Medicine 2018
Li J, Qiu B and Zhen D. Meta-analysis on clinical outcomes of the SuperPATH approach versus traditional approach in hip arthroplasty. Chinese Journal of Tissue Engineering Research 2018; 22: 2453-2460.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Keisuke Hagio, Kazuhisa Aikawa
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
