Randomized controlled trial of comparison between the SuperPATH and posterolateral approaches in total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

OUYANG Chenbo ^1,2 , WANG Haoyang ¹ , MENG Weikun ¹ , LUO Zeyu ¹ , WANG Duan ¹ , PEI Fuxing ¹ ,  ZHOU Zongke ¹

1. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
2. Department of Orthopaedics, Chengdu 363 Hospital of China Aviation Industry, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

ZHOU Zongke, Email: zongke@126.com

Keywords：

Total hip arthroplasty; SuperPATH approach; posterolateral approach; minimally invasive

DOI：

10.7507/1002-1892.201807011

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Objective To evaluate the effectiveness of SuperPATH approach in total hip arthroplasty (THA) compared with conventional posterolateral approach. Methods Between March 2017 and May 2017, 24 patients who planned to have a unilateral THA were enrolled in the study and randomized into 2 groups. Twelve patients were treated with SuperPATH approach (SuperPATH group) and 12 patients with posterolateral approach (control group). There was no significant difference in gender, age, body mass index, the type of disease, complicating diseases, and American Society of Anesthesiologists grading between 2 groups (P>0.05). The operation time, length of stay, length of incision, and perioperative complications related to operation were recorded. The hemoglobin and hematocrit were recorded; the total blood loss and intraoperative blood loss were calculated. The inflammatory response indicators (C-reactive protein, erythrocyte sedimentation rate) and muscle damage index (creatine kinase) were recorded in both groups. The range of motion, functional score (Harris score), visual analogue scale (VAS) score, and prosthesis position were recorded. Results Patients in both groups were followed up 1 year. Compared with the control group, the operation time of the SuperPATH group was longer (t=4.470, P=0.000), and the incision was shorter (t=–2.168, P=0.041). There was no significant difference in length of stay between 2 groups (t=0.474, P=0.640). Periprosthetic fracture occurred in 1 case of the SuperPATH group. No other complications, such as infection or deep vein thrombosis, occurred in both groups. There was no significant difference in intraoperative blood loss, total blood loss, hemoglobin and hematocrit before operation and at 1 and 3 days after operation, and C-reactive protein and erythrocyte sedimentation rate before operation and at 1, 3, and 14 days between 2 groups (P>0.05). For creatine kinase, SuperPATH group at 1 and 3 days were lower than control group (P<0.05), while no significant difference was found between 2 groups before operation and at 14 days after operation (P>0.05). For flexion and abduction activity, SuperPATH group at 1 and 3 days after operation were better than the control group (P<0.05), while no significant difference was found between 2 groups at 14 days, 3 months, 6 months, and 1 year after operation (P>0.05). The Harris and VAS scores of SuperPATH group at 1 and 3 days after operation were better than those of control group (P<0.05). There was no significant difference in anteversion and abduction between 2 groups (P>0.05) according to the X-ray film at 1 year. During the follow-up, no loosening or migration was observed. Conclusion Compared with the posterolateral approach, the SuperPATH approach can reduce muscle damage, relieve early pain, promote recovery, and obtain the similar short-term effectiveness.

Citation： OUYANG Chenbo, WANG Haoyang, MENG Weikun, LUO Zeyu, WANG Duan, PEI Fuxing, ZHOU Zongke. Randomized controlled trial of comparison between the SuperPATH and posterolateral approaches in total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(12): 1500-1506. doi: 10.7507/1002-1892.201807011 Copy

1.	Cardenas-Nylander C, Bellotti V, Astarita E, et al. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Hip Int, 2016, 26(Suppl 1): 34-37.
2.	Chow J, Penenberg B, Murphy S. Modified micro-superior percutaneously-assisted total hip: early experiences & case reports. Curr Rev Musculoskelet Med, 2011, 4(3): 146-150.
3.	顏廷題, 田少奇, 王遠賀, 等. SuperPATH 與 Hardinge 入路全髖關節置換術早期臨床療效比較. 中國修復重建外科雜志, 2017, 31(1): 17-22.
4.	姚堅, 丁海. SuperPath 微創人工全髖關節置換術的研究進展. 中國修復重建外科雜志, 2016, 30(9): 1170-1173.
5.	喬高山, 朱成棟, 朱樂銀, 等. SuperPATH 微創與常規入路行全髖關節置換術的早期療效比較. 生物骨科材料與臨床研究, 2018, 15(1): 52-54.
6.	何啟新, 喬巨峰, 劉永青. SuperPath 微創人工全髖關節置換術與常規全髖關節置換術早期療效比較. 廣東醫學院學報, 2016, 34(3): 289-292.
7.	孫彥平, 劉月坤, 崔曉亮, 等. Superpath 全髖置換與全髖關節置換術的療效、疼痛程度及髖關節功能分析. 中華骨與關節外科雜志, 2017, 10(4): 305-307.
8.	袁宏謀, 朱佳俊, 孫振國, 等. SuperPATH 入路與后外側入路行人工全髖關節置換術的療效比較. 中國修復重建外科雜志, 2018, 32(1): 14-19.
9.	Yi Z, Bin S, Jing Y, et al. Tranexamic Acid administration in primary total hip arthroplasty: A randomized controlled trial of intravenous combined with topical versus single-dose intravenous administration. J Bone Joint Surg (Am), 2016, 98(12): 983-991.
10.	沈彬, 翁習生, 廖刃, 等. 中國髖、膝關節置換術加速康復—圍術期疼痛與睡眠管理專家共識. 中華骨與關節外科雜志, 2016, 9(2): 91-97.
11.	張穎, 何偉, 劉又文, 等. 偏心固定與髓內固定治療股骨轉子間骨折的病例對照研究. 中國骨傷, 2015, 18(2): 117-121.
12.	Xie J, Ma J, Yue C, et al. Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial. Hip Int, 2016, 26(1): 36-42.
13.	Luo ZY, Wang HY, Wang D, et al. Oral vs intravenous vs topical tranexamic acid in primary hip arthroplasty: A prospective, randomized, double-blind, controlled study. J Arthroplasty, 2018, 33(3): 786-793.
14.	Chow J, Fitch DA. In-hospital costs for total hip replacement performed using the supercapsular percutaneously-assisted total hip replacement surgical technique. Int Orthop, 2017, 41(6): 1119-1123.
15.	Cronin MD, Gofton W, Erwin L, et al. Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty: protocol for a randomized, controlled study. Ann Transl Med, 2015, 3(21): 335.
16.	任東偉, 楊革軍, 趙華磊, 等. SuperPath 切口微創人工全髖關節置換術對股骨頭壞死療效及生活質量的影響. 河北醫科大學學報, 2016, 37(12): 1416-1419.
17.	Bodrogi AW, Sciortino R, Fitch DA, et al. Use of the supercapsular percutaneously assisted total hip approach for femoral neck fractures: surgical technique and case series. J Orthop Surg Res, 2016, 11(1): 113.
18.	Rasuli KJ, Gofton W. Percutaneously assisted total hip (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Ann Transl Med, 2015, 3(13): 179.

1. Cardenas-Nylander C, Bellotti V, Astarita E, et al. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Hip Int, 2016, 26(Suppl 1): 34-37.
2. Chow J, Penenberg B, Murphy S. Modified micro-superior percutaneously-assisted total hip: early experiences & case reports. Curr Rev Musculoskelet Med, 2011, 4(3): 146-150.
3. 顏廷題, 田少奇, 王遠賀, 等. SuperPATH 與 Hardinge 入路全髖關節置換術早期臨床療效比較. 中國修復重建外科雜志, 2017, 31(1): 17-22.
4. 姚堅, 丁海. SuperPath 微創人工全髖關節置換術的研究進展. 中國修復重建外科雜志, 2016, 30(9): 1170-1173.
5. 喬高山, 朱成棟, 朱樂銀, 等. SuperPATH 微創與常規入路行全髖關節置換術的早期療效比較. 生物骨科材料與臨床研究, 2018, 15(1): 52-54.
6. 何啟新, 喬巨峰, 劉永青. SuperPath 微創人工全髖關節置換術與常規全髖關節置換術早期療效比較. 廣東醫學院學報, 2016, 34(3): 289-292.
7. 孫彥平, 劉月坤, 崔曉亮, 等. Superpath 全髖置換與全髖關節置換術的療效、疼痛程度及髖關節功能分析. 中華骨與關節外科雜志, 2017, 10(4): 305-307.
8. 袁宏謀, 朱佳俊, 孫振國, 等. SuperPATH 入路與后外側入路行人工全髖關節置換術的療效比較. 中國修復重建外科雜志, 2018, 32(1): 14-19.
9. Yi Z, Bin S, Jing Y, et al. Tranexamic Acid administration in primary total hip arthroplasty: A randomized controlled trial of intravenous combined with topical versus single-dose intravenous administration. J Bone Joint Surg (Am), 2016, 98(12): 983-991.
10. 沈彬, 翁習生, 廖刃, 等. 中國髖、膝關節置換術加速康復—圍術期疼痛與睡眠管理專家共識. 中華骨與關節外科雜志, 2016, 9(2): 91-97.
11. 張穎, 何偉, 劉又文, 等. 偏心固定與髓內固定治療股骨轉子間骨折的病例對照研究. 中國骨傷, 2015, 18(2): 117-121.
12. Xie J, Ma J, Yue C, et al. Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial. Hip Int, 2016, 26(1): 36-42.
13. Luo ZY, Wang HY, Wang D, et al. Oral vs intravenous vs topical tranexamic acid in primary hip arthroplasty: A prospective, randomized, double-blind, controlled study. J Arthroplasty, 2018, 33(3): 786-793.
14. Chow J, Fitch DA. In-hospital costs for total hip replacement performed using the supercapsular percutaneously-assisted total hip replacement surgical technique. Int Orthop, 2017, 41(6): 1119-1123.
15. Cronin MD, Gofton W, Erwin L, et al. Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty: protocol for a randomized, controlled study. Ann Transl Med, 2015, 3(21): 335.
16. 任東偉, 楊革軍, 趙華磊, 等. SuperPath 切口微創人工全髖關節置換術對股骨頭壞死療效及生活質量的影響. 河北醫科大學學報, 2016, 37(12): 1416-1419.
17. Bodrogi AW, Sciortino R, Fitch DA, et al. Use of the supercapsular percutaneously assisted total hip approach for femoral neck fractures: surgical technique and case series. J Orthop Surg Res, 2016, 11(1): 113.
18. Rasuli KJ, Gofton W. Percutaneously assisted total hip (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Ann Transl Med, 2015, 3(13): 179.

Chinese Journal of Reparative and Reconstructive Surgery

Randomized controlled trial of comparison between the SuperPATH and posterolateral approaches in total hip arthroplasty

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