Loading…
Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty
Introduction In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefit...
Saved in:
| Published in: | European journal of orthopaedic surgery & traumatology 2018-08, Vol.28 (6), p.1111-1116 |
|---|---|
| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43 |
| container_end_page | 1116 |
| container_issue | 6 |
| container_start_page | 1111 |
| container_title | European journal of orthopaedic surgery & traumatology |
| container_volume | 28 |
| creator | Kanda, Akio Kaneko, Kazuo Obayashi, Osamu Mogami, Atsuhiko Morohashi, Itaru |
| description | Introduction
In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate.
Methods
We evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery.
Results
The width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study.
Conclusions
We cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate.
Level of evidence
Therapeutic, Level IV. |
| doi_str_mv | 10.1007/s00590-018-2166-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6060957</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2012916022</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43</originalsourceid><addsrcrecordid>eNp1kU1rHDEMhofS0qRJf0AvxdBLL9PK9thjXwoltGkhkBxyN16vNuMwO57KnkD-fT1skn5AQGAjPXol8TbNOw6fOED_OQMoCy1w0wqudSteNMe8k6LloM3L-tdStga0Omre5HwLwJXl6nVzJKwS0vbdcbNcEWakO19imljasTIg81RiWEZPLPg5L2PNTFuWh0SFjb4g-ZFRKr4kYnFi20gYSmVqJdaUn2dKPgyspBqlwkOcV9GB0jz6XO5Pm1c7P2Z8-_CeNNffv12f_WgvLs9_nn29aIM0SrSe77jujAwGkfdGBVCiB9vhVgKYjQ7BgpS9Cp0Q1ghlNl0N7HoEj9jJk-bLQXZeNnvcBpxKXd3NFPee7l3y0f1bmeLgbtKd06DBqr4KfHwQoPRrwVzcPuaA4-gnTEt2AriwXIMQFf3wH3qbFprqdU5IxZXujVkpfqACpZwJd0_LcHCrp-7gqaueutVTt_a8__uKp45HEysgDkCupekG6c_o51V_A3kCrjw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2351567882</pqid></control><display><type>article</type><title>Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty</title><source>Springer Link</source><creator>Kanda, Akio ; Kaneko, Kazuo ; Obayashi, Osamu ; Mogami, Atsuhiko ; Morohashi, Itaru</creator><creatorcontrib>Kanda, Akio ; Kaneko, Kazuo ; Obayashi, Osamu ; Mogami, Atsuhiko ; Morohashi, Itaru</creatorcontrib><description>Introduction
In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate.
Methods
We evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery.
Results
The width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study.
Conclusions
We cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate.
Level of evidence
Therapeutic, Level IV.</description><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-018-2166-2</identifier><identifier>PMID: 29523974</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Aged ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - methods ; Female ; Femur Head Necrosis - surgery ; Hip Dislocation - etiology ; Hip Dislocation - prevention & control ; Hip joint ; Hip Joint - surgery ; Humans ; Hydroxyapatite ; Joint Capsule - surgery ; Joint replacement surgery ; Joint surgery ; Laparoscopy ; Magnetic resonance imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Muscle Strength ; Muscle, Skeletal - surgery ; Musculoskeletal system ; Original Article • HIP - ARTHROPLASTY ; Original • HIP - ARTHROPLASTY ; Osteoarthritis, Hip - surgery ; Postoperative period ; Studies ; Surgical Orthopedics ; Surgical techniques ; Transplants & implants ; Traumatic Surgery</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2018-08, Vol.28 (6), p.1111-1116</ispartof><rights>The Author(s) 2018</rights><rights>European Journal of Orthopaedic Surgery and Traumatology is a copyright of Springer, (2018). All Rights Reserved. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43</citedby><cites>FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43</cites><orcidid>0000-0002-5434-9959</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29523974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kanda, Akio</creatorcontrib><creatorcontrib>Kaneko, Kazuo</creatorcontrib><creatorcontrib>Obayashi, Osamu</creatorcontrib><creatorcontrib>Mogami, Atsuhiko</creatorcontrib><creatorcontrib>Morohashi, Itaru</creatorcontrib><title>Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Introduction
In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate.
Methods
We evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery.
Results
The width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study.
Conclusions
We cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate.
Level of evidence
Therapeutic, Level IV.</description><subject>Aged</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Female</subject><subject>Femur Head Necrosis - surgery</subject><subject>Hip Dislocation - etiology</subject><subject>Hip Dislocation - prevention & control</subject><subject>Hip joint</subject><subject>Hip Joint - surgery</subject><subject>Humans</subject><subject>Hydroxyapatite</subject><subject>Joint Capsule - surgery</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Laparoscopy</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Muscle Strength</subject><subject>Muscle, Skeletal - surgery</subject><subject>Musculoskeletal system</subject><subject>Original Article • HIP - ARTHROPLASTY</subject><subject>Original • HIP - ARTHROPLASTY</subject><subject>Osteoarthritis, Hip - surgery</subject><subject>Postoperative period</subject><subject>Studies</subject><subject>Surgical Orthopedics</subject><subject>Surgical techniques</subject><subject>Transplants & implants</subject><subject>Traumatic Surgery</subject><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kU1rHDEMhofS0qRJf0AvxdBLL9PK9thjXwoltGkhkBxyN16vNuMwO57KnkD-fT1skn5AQGAjPXol8TbNOw6fOED_OQMoCy1w0wqudSteNMe8k6LloM3L-tdStga0Omre5HwLwJXl6nVzJKwS0vbdcbNcEWakO19imljasTIg81RiWEZPLPg5L2PNTFuWh0SFjb4g-ZFRKr4kYnFi20gYSmVqJdaUn2dKPgyspBqlwkOcV9GB0jz6XO5Pm1c7P2Z8-_CeNNffv12f_WgvLs9_nn29aIM0SrSe77jujAwGkfdGBVCiB9vhVgKYjQ7BgpS9Cp0Q1ghlNl0N7HoEj9jJk-bLQXZeNnvcBpxKXd3NFPee7l3y0f1bmeLgbtKd06DBqr4KfHwQoPRrwVzcPuaA4-gnTEt2AriwXIMQFf3wH3qbFprqdU5IxZXujVkpfqACpZwJd0_LcHCrp-7gqaueutVTt_a8__uKp45HEysgDkCupekG6c_o51V_A3kCrjw</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Kanda, Akio</creator><creator>Kaneko, Kazuo</creator><creator>Obayashi, Osamu</creator><creator>Mogami, Atsuhiko</creator><creator>Morohashi, Itaru</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5434-9959</orcidid></search><sort><creationdate>20180801</creationdate><title>Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty</title><author>Kanda, Akio ; Kaneko, Kazuo ; Obayashi, Osamu ; Mogami, Atsuhiko ; Morohashi, Itaru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Female</topic><topic>Femur Head Necrosis - surgery</topic><topic>Hip Dislocation - etiology</topic><topic>Hip Dislocation - prevention & control</topic><topic>Hip joint</topic><topic>Hip Joint - surgery</topic><topic>Humans</topic><topic>Hydroxyapatite</topic><topic>Joint Capsule - surgery</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Laparoscopy</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Muscle Strength</topic><topic>Muscle, Skeletal - surgery</topic><topic>Musculoskeletal system</topic><topic>Original Article • HIP - ARTHROPLASTY</topic><topic>Original • HIP - ARTHROPLASTY</topic><topic>Osteoarthritis, Hip - surgery</topic><topic>Postoperative period</topic><topic>Studies</topic><topic>Surgical Orthopedics</topic><topic>Surgical techniques</topic><topic>Transplants & implants</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kanda, Akio</creatorcontrib><creatorcontrib>Kaneko, Kazuo</creatorcontrib><creatorcontrib>Obayashi, Osamu</creatorcontrib><creatorcontrib>Mogami, Atsuhiko</creatorcontrib><creatorcontrib>Morohashi, Itaru</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kanda, Akio</au><au>Kaneko, Kazuo</au><au>Obayashi, Osamu</au><au>Mogami, Atsuhiko</au><au>Morohashi, Itaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>28</volume><issue>6</issue><spage>1111</spage><epage>1116</epage><pages>1111-1116</pages><issn>1633-8065</issn><eissn>1432-1068</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Introduction
In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate.
Methods
We evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery.
Results
The width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study.
Conclusions
We cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate.
Level of evidence
Therapeutic, Level IV.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>29523974</pmid><doi>10.1007/s00590-018-2166-2</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-5434-9959</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1633-8065 |
| ispartof | European journal of orthopaedic surgery & traumatology, 2018-08, Vol.28 (6), p.1111-1116 |
| issn | 1633-8065 1432-1068 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6060957 |
| source | Springer Link |
| subjects | Aged Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - methods Female Femur Head Necrosis - surgery Hip Dislocation - etiology Hip Dislocation - prevention & control Hip joint Hip Joint - surgery Humans Hydroxyapatite Joint Capsule - surgery Joint replacement surgery Joint surgery Laparoscopy Magnetic resonance imaging Male Medicine Medicine & Public Health Middle Aged Muscle Strength Muscle, Skeletal - surgery Musculoskeletal system Original Article • HIP - ARTHROPLASTY Original • HIP - ARTHROPLASTY Osteoarthritis, Hip - surgery Postoperative period Studies Surgical Orthopedics Surgical techniques Transplants & implants Traumatic Surgery |
| title | Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-22T01%3A34%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Preservation%20of%20the%20articular%20capsule%20and%20short%20lateral%20rotator%20in%20direct%20anterior%20approach%20to%20total%20hip%20arthroplasty&rft.jtitle=European%20journal%20of%20orthopaedic%20surgery%20&%20traumatology&rft.au=Kanda,%20Akio&rft.date=2018-08-01&rft.volume=28&rft.issue=6&rft.spage=1111&rft.epage=1116&rft.pages=1111-1116&rft.issn=1633-8065&rft.eissn=1432-1068&rft_id=info:doi/10.1007/s00590-018-2166-2&rft_dat=%3Cproquest_pubme%3E2012916022%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3852-a1f16483c8ee1785c0527094ed3008b6cc903375c42298258b48b4e47e0aee43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2351567882&rft_id=info:pmid/29523974&rfr_iscdi=true |