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.	颜廷题, 田少奇, 王远贺, 等. SuperPATH 与 Hardinge 入路全髋关节置换术早期临床疗效比较. 中国修复重建外科杂志, 2017, 31(1): 17-22.
4.	姚坚, 丁海. SuperPath 微创人工全髋关节置换术的研究进展. 中国修复重建外科杂志, 2016, 30(9): 1170-1173.
5.	乔高山, 朱成栋, 朱乐银, 等. SuperPATH 微创与常规入路行全髋关节置换术的早期疗效比较. 生物骨科材料与临床研究, 2018, 15(1): 52-54.
6.	何启新, 乔巨峰, 刘永青. SuperPath 微创人工全髋关节置换术与常规全髋关节置换术早期疗效比较. 广东医学院学报, 2016, 34(3): 289-292.
7.	孙彦平, 刘月坤, 崔晓亮, 等. Superpath 全髋置换与全髋关节置换术的疗效、疼痛程度及髋关节功能分析. 中华骨与关节外科杂志, 2017, 10(4): 305-307.
8.	袁宏谋, 朱佳俊, 孙振国, 等. SuperPATH 入路与后外侧入路行人工全髋关节置换术的疗效比较. 中国修复重建外科杂志, 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, 翁习生, 廖刃, 等. 中国髋、膝关节置换术加速康复—围术期疼痛与睡眠管理专家共识. 中华骨与关节外科杂志, 2016, 9(2): 91-97.
11.	张颖, 何伟, 刘又文, 等. 偏心固定与髓内固定治疗股骨转子间骨折的病例对照研究. 中国骨伤, 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.	任东伟, 杨革军, 赵华磊, 等. SuperPath 切口微创人工全髋关节置换术对股骨头坏死疗效及生活质量的影响. 河北医科大学学报, 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. 颜廷题, 田少奇, 王远贺, 等. SuperPATH 与 Hardinge 入路全髋关节置换术早期临床疗效比较. 中国修复重建外科杂志, 2017, 31(1): 17-22.
4. 姚坚, 丁海. SuperPath 微创人工全髋关节置换术的研究进展. 中国修复重建外科杂志, 2016, 30(9): 1170-1173.
5. 乔高山, 朱成栋, 朱乐银, 等. SuperPATH 微创与常规入路行全髋关节置换术的早期疗效比较. 生物骨科材料与临床研究, 2018, 15(1): 52-54.
6. 何启新, 乔巨峰, 刘永青. SuperPath 微创人工全髋关节置换术与常规全髋关节置换术早期疗效比较. 广东医学院学报, 2016, 34(3): 289-292.
7. 孙彦平, 刘月坤, 崔晓亮, 等. Superpath 全髋置换与全髋关节置换术的疗效、疼痛程度及髋关节功能分析. 中华骨与关节外科杂志, 2017, 10(4): 305-307.
8. 袁宏谋, 朱佳俊, 孙振国, 等. SuperPATH 入路与后外侧入路行人工全髋关节置换术的疗效比较. 中国修复重建外科杂志, 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, 翁习生, 廖刃, 等. 中国髋、膝关节置换术加速康复—围术期疼痛与睡眠管理专家共识. 中华骨与关节外科杂志, 2016, 9(2): 91-97.
11. 张颖, 何伟, 刘又文, 等. 偏心固定与髓内固定治疗股骨转子间骨折的病例对照研究. 中国骨伤, 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. 任东伟, 杨革军, 赵华磊, 等. SuperPath 切口微创人工全髋关节置换术对股骨头坏死疗效及生活质量的影响. 河北医科大学学报, 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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