| A comparison of a less invasive piriformis-sparing approach versus the standard posterior approach to the hip: A randomised controlled trial. | |
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MedLine Citation:
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PMID: 22219246 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We undertook a randomised controlled trial to compare the piriformis-sparing approach with the standard posterior approach used for total hip replacement (THR). We recruited 100 patients awaiting THR and randomly allocated them to either the piriformis-sparing approach or the standard posterior approach. Pre- and post-operative care programmes and rehabilitation regimes were identical for both groups. Observers were blinded to the allocation throughout; patients were blinded until the two-week assessment. Follow-up was at six weeks, three months, one year and two years. In all 11 patients died or were lost to follow-up. There was no significant difference between groups for any of the functional outcomes. However, for patients in the piriformis-sparing group there was a trend towards a better six-minute walk test at two weeks and greater patient satisfaction at six weeks. The acetabular components were less anteverted (p = 0.005) and had a lower mean inclination angle (p = 0.02) in the piriformis-sparing group. However, in both groups the mean component positions were within Lewinnek's safe zone. Surgeons perceived the piriformis-sparing approach to be significantly more difficult than the standard approach (p = 0.03), particularly in obese patients. In conclusion, performing THR through a shorter incision involving sparing piriformis is more difficult and only provides short-term benefits compared with the standard posterior approach. |
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Authors:
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R J K Khan; D Maor; M Hofmann; S Haebich |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of bone and joint surgery. British volume Volume: 94 ISSN: 0301-620X ISO Abbreviation: J Bone Joint Surg Br Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375355 Medline TA: J Bone Joint Surg Br Country: England |
Other Details:
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Languages: eng Pagination: 43-50 Citation Subset: AIM; IM |
Affiliation:
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University of Western Australia, Department of Surgery, Nedlands, Western Australia 6009, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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