The length of distal skin incision of the postero-lateral approach affects the cup inclination during the total hip arthroplasty

Authors : Aziz ÇATALTEPE

Pages : 1238-1245

Doi:10.32322/jhsm.1071852

View : 25 | Download : 11

Publication Date : 2022-09-25

Article Type : Research Paper

Abstract :Aim: The primary aim of the study was to determine whether the length of the distal skin incision of the posterolateral approach affects the cup inclination during total hip arthroplasty insert ignore into journalissuearticles values(THA);. Material and Method: In this study, a cohort of 71 consecutive patients who performed between January 2017 and December 2021 with unilateral THA using a posterolateral approach was retrospectively assessed. Two groups were formed according to acetabular cup inclination with normal anteversion angle. There were 56 hips in the inside group and 17 in the outside group. A curvilinear skin incision of around 13 cm was performed. Component position evaluation was carried out through a radiographic assessment of the acetabular component on an anteroposterior pelvis radiograph. The rate of an outlier was compared between groups according to the safe zone defined as 30° to 50° of inclination and 5° to 25° of anteversion, which was described by Lewinnek et al. Results: No significant difference in the average total incision length was found between the two groups insert ignore into journalissuearticles values(p=0.207);. While the average distal incision length was 7.91±0.62 cm insert ignore into journalissuearticles values(range, 6.8-9 cm); in the inside group and 6.37±0.21 cm insert ignore into journalissuearticles values(range, 6-6.7 cm); in the outside group. According to ROC analysis, a patient with ≤6.7 cm of the distal length of incision insert ignore into journalissuearticles values(DLI); was 5.71 times more likely to be outside than a patient with >6.7 cm of DLI. Seventeen hips insert ignore into journalissuearticles values(23.3%); were found outside the safe range. Substantial differences were observed regarding radiographic cup inclination between the two groups insert ignore into journalissuearticles values(p=0.0001);. In the inside group, the average cup inclination was 44.11°±3.44° insert ignore into journalissuearticles values(range, 37°-50°);, whereas, in the outside group, it was 55.41°±2.5° insert ignore into journalissuearticles values(range, 52°-59°);. However, there were no significant differences in the average radiographic cup anteversion between the two groups insert ignore into journalissuearticles values(p=0.960);. Although 11 of 17 insert ignore into journalissuearticles values(64.5%); patients were classified as obese insert ignore into journalissuearticles values(BMI ≥30); in the outside group experienced higher rates of inaccurate cup orientation, logistic regression analysis showed that the individual effects of obesity on the occurrence of the inaccurate cup position were not observed insert ignore into journalissuearticles values(p=0.884);. One posterior hip dislocation occurred after one month postoperative in the outside group. Conclusions: Longer distal portion of the skin incision of the posterolateral approach should be performed to achieve optimal operative inclination angles of the acetabular cup during THA. The surgeon must have no hesitation in extending the distal skin incision when adopting the posterolateral approach.
Keywords : Total hip arthroplasty, posterior approach, distal length of incision, acetabular cup inclination, body mass index