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General Orthopaedics

OUTCOMES FOR OVER 1000 CONSECUTIVE TOTAL HIP REPLACEMENTS USING THE SUPERCAPSULAR PERCUTANEOUSLY ASSISTED TOTAL HIP REPLACEMENT SURGICAL TECHNIQUE

The International Society for Technology in Arthroplasty (ISTA), 29th Annual Congress, October 2016. PART 1.



Abstract

Introduction

Total hip replacement (THR) is one of the most successful orthopedic surgeries performed today. Long term success of THR has been well established, but there remains significant room to improve early outcomes (e.g. pain, length of hospital stay, readmissions). The surgical technique is a key variable affecting these early outcomes. The objective of the current study was to evaluate outcomes for over 1,000 consecutive THRs using the supercapsular percutaneously-assisted total hip (SuperPath) approach.

Patients and Methods

Between September 2008 and April 2015, one surgeon performed 1,074 consecutive primary THRs using the SuperPath surgical technique. All THRs were performed without local anesthesia, patient controlled analgesia (PCA), or postoperative hip precautions. Surgical outcomes including operative time, blood loss, incision length, length of stay (LOS), and complications were collected as part of this IRB approved study. Harris Hip Scores (HHS) and UCLA scores were obtained preoperatively and at 6 and 12 months postoperatively.

Results

The mean operative time, blood loss, incision length, and LOS were 75 minutes (range, 40–141), 150 mL (range, 50–900), 7.4 cm (range, 5–12), and 1.4 days, respectively. In total there were 29 complications including: 6 (0.5%) periprosthetic fractures; 4 (0.3%) thromboembolisms; 3 (0.2%) subsidence; 2 (0.1%) heterotropic ossifications; and 1 (0.09%) dislocation. There were no instances of infection or neurovascular injury. Mean HHS improved from 45.4 preoperatively to 89.9 and 87.2 at 6 and 12 months, respectively. Mean UCLA scores improved from 3.9 preoperatively to 5.5 and 5.6 at 6 and 12 months, respectively.

Conclusions

These results from over 1,000 consecutive THRs using the SuperPath technique demonstrate this technique is safe and reliable, with results similar or better than those reported for other THR surgical techniques. There was a low rate of complications with an even distribution and no bias to early cases.


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