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The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases

The SuperPATH approach is a direct superior portal-assisted approach for total hip arthroplasty (THA) that utilizes the interval between the gluteus minimus and the piriformis to access the hip capsule. Patients and Methods: SuperPATH arthroplasty was performed by a single surgeon between December o...

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Autores principales: Flevas, Dimitrios A., Tsakotos, Georgios A., Benakis, Leonardos N., Sasalos, Grigorios G., Tokis, Anastasios V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318286/
https://www.ncbi.nlm.nih.gov/pubmed/35888071
http://dx.doi.org/10.3390/life12070981
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author Flevas, Dimitrios A.
Tsakotos, Georgios A.
Benakis, Leonardos N.
Sasalos, Grigorios G.
Tokis, Anastasios V.
author_facet Flevas, Dimitrios A.
Tsakotos, Georgios A.
Benakis, Leonardos N.
Sasalos, Grigorios G.
Tokis, Anastasios V.
author_sort Flevas, Dimitrios A.
collection PubMed
description The SuperPATH approach is a direct superior portal-assisted approach for total hip arthroplasty (THA) that utilizes the interval between the gluteus minimus and the piriformis to access the hip capsule. Patients and Methods: SuperPATH arthroplasty was performed by a single surgeon between December of 2016 and December of 2021 in 344 cases. The technique described by Chow was performed in all cases. The average length of stay was 1.3 days, and all patients were discharged for home. All patients were mobilized on the day of the operation. Six cases presented complications: four intraoperative femur fractures and two peroneal nerve palsies. No infection and no hip dislocation were noticed in any case. Modifications: We recommend that the patient be placed as far from the surgeon as possible as well as the use of a sterilized standard linen pack to elevate the foot and internally rotate the hip. In addition, regarding instrumentation, we recommend the use of a 4.5 mm drill for the first guidance femur drilling and a standard corkscrew for femoral head removal. Finally, we propose a different reduction technique using a hook. The use of the SuperPATH approach allows for maximal tissue sparing through preservation of external rotators and minimizing stretching of the gluteus medius. There is no range of motion restrictions postoperatively and patients can achieve a high level of function with a very low dislocation risk and reduced inpatient stay. Furthermore, an incision extension is possible if needed in complex cases. For surgeons familiar with the standard posterolateral approach, the SuperPATH approach is a reliable and safe method with promising results for the patient. In order to improve the surgical effect and facilitate some steps in the procedure, we share our experience and recommend some modifications.
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spelling pubmed-93182862022-07-27 The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases Flevas, Dimitrios A. Tsakotos, Georgios A. Benakis, Leonardos N. Sasalos, Grigorios G. Tokis, Anastasios V. Life (Basel) Technical Note The SuperPATH approach is a direct superior portal-assisted approach for total hip arthroplasty (THA) that utilizes the interval between the gluteus minimus and the piriformis to access the hip capsule. Patients and Methods: SuperPATH arthroplasty was performed by a single surgeon between December of 2016 and December of 2021 in 344 cases. The technique described by Chow was performed in all cases. The average length of stay was 1.3 days, and all patients were discharged for home. All patients were mobilized on the day of the operation. Six cases presented complications: four intraoperative femur fractures and two peroneal nerve palsies. No infection and no hip dislocation were noticed in any case. Modifications: We recommend that the patient be placed as far from the surgeon as possible as well as the use of a sterilized standard linen pack to elevate the foot and internally rotate the hip. In addition, regarding instrumentation, we recommend the use of a 4.5 mm drill for the first guidance femur drilling and a standard corkscrew for femoral head removal. Finally, we propose a different reduction technique using a hook. The use of the SuperPATH approach allows for maximal tissue sparing through preservation of external rotators and minimizing stretching of the gluteus medius. There is no range of motion restrictions postoperatively and patients can achieve a high level of function with a very low dislocation risk and reduced inpatient stay. Furthermore, an incision extension is possible if needed in complex cases. For surgeons familiar with the standard posterolateral approach, the SuperPATH approach is a reliable and safe method with promising results for the patient. In order to improve the surgical effect and facilitate some steps in the procedure, we share our experience and recommend some modifications. MDPI 2022-06-30 /pmc/articles/PMC9318286/ /pubmed/35888071 http://dx.doi.org/10.3390/life12070981 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Technical Note
Flevas, Dimitrios A.
Tsakotos, Georgios A.
Benakis, Leonardos N.
Sasalos, Grigorios G.
Tokis, Anastasios V.
The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title_full The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title_fullStr The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title_full_unstemmed The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title_short The Supercapsular Percutaneously Assisted Total Hip (SuperPATH) Approach Revisited: Technique Improvements after the Perioperative Experience of 344 Cases
title_sort supercapsular percutaneously assisted total hip (superpath) approach revisited: technique improvements after the perioperative experience of 344 cases
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318286/
https://www.ncbi.nlm.nih.gov/pubmed/35888071
http://dx.doi.org/10.3390/life12070981
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