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Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study

Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves pir...

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Autores principales: Kenanidis, Eustathios, Milonakis, Nikolaos, Georgios, Foukarakis, Potoupnis, Michael, Tsiridis, Eleftherios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125016/
https://www.ncbi.nlm.nih.gov/pubmed/37094283
http://dx.doi.org/10.1051/sicotj/2023008
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author Kenanidis, Eustathios
Milonakis, Nikolaos
Georgios, Foukarakis
Potoupnis, Michael
Tsiridis, Eleftherios
author_facet Kenanidis, Eustathios
Milonakis, Nikolaos
Georgios, Foukarakis
Potoupnis, Michael
Tsiridis, Eleftherios
author_sort Kenanidis, Eustathios
collection PubMed
description Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon. Methods: Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016–2017 and 2020–2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up. Results: The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months. Conclusions: The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure.
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spelling pubmed-101250162023-04-25 Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study Kenanidis, Eustathios Milonakis, Nikolaos Georgios, Foukarakis Potoupnis, Michael Tsiridis, Eleftherios SICOT J Original Article Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon. Methods: Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016–2017 and 2020–2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up. Results: The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months. Conclusions: The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure. EDP Sciences 2023-04-21 /pmc/articles/PMC10125016/ /pubmed/37094283 http://dx.doi.org/10.1051/sicotj/2023008 Text en © The Authors, published by EDP Sciences, 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kenanidis, Eustathios
Milonakis, Nikolaos
Georgios, Foukarakis
Potoupnis, Michael
Tsiridis, Eleftherios
Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title_full Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title_fullStr Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title_full_unstemmed Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title_short Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study
title_sort superior transverse atraumatic reconstruction (star) approach provides a better-compared outcome to standard direct superior approach (dsa): a matched, prospective comparative single-surgeon study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125016/
https://www.ncbi.nlm.nih.gov/pubmed/37094283
http://dx.doi.org/10.1051/sicotj/2023008
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