Abstract
INTRODUCTION
Proponents of the THA anterior approach have advocated for the use of dedicated surgical tables similar to those used in lower extremity fracture care that allow for traction, rotation, and angulation of the limb during surgery. Some tables require a specially-trained assistant to manipulate the table, whereas some may be manipulated by the surgeon. The purpose of this study is to compare the clinical outcomes in patients who underwent THA through an anterior approach on an assistant-controlled (AC) versus a surgeon-controlled (SC) table.
METHODS
This is a retrospective study of 343 consecutive THA patients from January 2017 – October 2017. Surgical and clinical data included surgical time, LOS, presence of pain (groin, hip, or thigh pain) at latest follow-up, and revision for any reason. Immediate postoperative radiographs were compared with latest follow-up radiographs to assess for LLD, stem alignment, and stem subsidence.
RESULTS
167 (48.7%) cases were performed using the AC table, and 176 (51.3%) were performed using the SC table. Overall, surgical time was significantly greater for surgeries which utilized the self-controlled table (70.2 minutes vs. 66.1 minutes, respectively). There was a statistically significant difference between the first and last third of cases performed on the SC table (73.6 minutes vs. 68.0 minutes, respectively). There were no significant differences in any clinical or radiographic outcomes.
DISCUSSION
Surgeons who routinely perform an anterior approach for THA can expect similar outcomes using an SC table as opposed to an AC table. Although surgical time with the SC table was longer by approximately four minutes, this difference is not clinically significant. In addition, surgical time with the SC table may be decreased following an initial learning curve. The SC table allows for greater surgeon control during the procedure and a significantly smaller institutional financial investment due to the reduced manpower required.
