COMPARISON OF EARLY FUNCTIONAL OUTCOMES BETWEEN TWO DIFFERENT SURGICAL APPROACHES FOR TOTAL HIP ARTHROPLASTY

Abstract

Total Hip Arthroplasty (THA) is considered the most successful treatment for advanced hiposteoarthritis. Different surgical approaches for THA are available and they have shown excellentoutcomes in the long-term follow-ups. However, few studies have analyzed the functional outcomes in thefirst days after a THA surgery. The purpose of this study was to compare the early functional outcomesbetween two different surgical techniques: a minimally invasive direct anterior approach (mini-DAA) anda postero-lateral approach (PL). Twelve patients for each group were analyzed. Pre- and postoperative(3, 10, 30 and 90 days after surgery) Patient-Reported Outcome Measures (PROMs) were administered:HOOS, HHS, VAS and SF-12-v2 scores. Moreover, comparison between surgical operation time andblood loss were examined. PROMs showed a significant improvement in the SF-12-v2 in the mini-DAAgroup compared to the PL group at 3 days after surgery: this difference was maintained also after 10 and30 days. In addition, HOOS and HHS were significantly ameliorated in the mini-DAA group starting 10days from surgery. In both groups, a physiological pain reduction was observed in the first days aftersurgery; comparing it to the pre-surgical VAS values, we found a significant improvement in the scoresfor the mini-DAA group after 30 days. Moreover, we demonstrated a significant reduction in blood lossfor the mini-DAA group. Surgical operation times were similar in the two groups; however, the durationof the mini-DAA procedure was shorter compared with the known literature. In this preliminary study,we demonstrated that the minimally invasive direct anterior approach for THA may lead to benefitsin the early postoperative time, as it allows for an improvement in functional outcomes, a reductionof postoperative pain, a reduction of hospitalization time and consequent reduction of postoperativecomplications; therefore, this surgical approach may consent an early return to work and daily activities.