Published by:
Lebrun D, et al. Poster 0051. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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Anterior, posterior approaches for outpatient THA yielded similar outcomes
Published by:
Lebrun D, et al. Poster 0051. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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Patients who underwent outpatient total hip arthroplasty experienced similar outcomes through either the anterior or posterior approach, according to results.
Using a standardized perioperative care pathway, Michael P. Ast, MD, of Hospital for Special Surgery, and colleagues compared length of surgery, time to ambulation, readmissions and 90-day occurrence of complications among patients who underwent THA through either the anterior approach (n=69) or the posterior approach (n=69) and were discharged within 24 hours.
Results showed patients who underwent the posterior approach had time to ambulation of approximately 6.3 hours vs. 5.7 hours for patients who underwent the anterior approach. Although the two groups had no significant differences for early ambulation, researchers found early ambulation within the first 5 hours predicted earlier discharge and decreased inpatient pain medication in both groups. Researchers also noted the two groups had no significant differences in length of surgery. Patients in the posterior approach group had a 4.3% occurrence of complication rate vs. 2.9% in the anterior approach group, according to results.
“While there have been prior studies comparing approaches, these studies have presented methodological concerns, including selection bias, poorly controlled perioperative protocols, inappropriate comparison groups or significant conflicts of interest. We carefully designed this study to focus on a matched group of the highest demand patients, ambulatory surgery patients, in a consistent and structured perioperative program to determine if either approach provided clinically relevant early advantages or disadvantages,” Ast told Healio Orthopedics. “Surgeons should take comfort that whichever approach for surgery they prefer can provide high-quality outcomes in an ambulatory surgery setting, while minimizing risks through an evidence-based, structed preoperative and recovery program.”
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