Authors
Pimanchev O.V.1, Popov N.V.1, Ryapolov Yu.V.1, Jojua A.V.1, Romanov D.A.2
1 Pirogov National Medical and Surgical Center, Moscow
2 First Moscow State Medical University named after I.M. Sechenov, Moscow
Abstract
Rationale. Recently, anterior approach for hip arthroplasty has become increasingly popular, which is explained by its less invasiveness and, as a result, the possible less postoperative pain syndrome.
Purpose of the study: to evaluate and compare postoperative pain syndrome and postoperative complications in patients undergoing total hip arthroplasty using anterior or anterolateral approaches.
Materials and methods. A prospective study was conducted in 50 patients with stage 3 coxarthrosis, who were divided into two groups using randomization methods: in the main group (n = 25) hip arthroplasty was performed using direct access, in the comparison group (n = 25) – anterior lateral access. Pain syndrome was assessed using a 100-point VAS scale before surgery, on the first and fifth days, and 1 month after surgery.
Results. The groups were comparable in terms of gender, age, side of the lesion, BMI, time of surgery and number of bed days (p>0.05). Also, there were no statistical differences in preoperative pain syndrome according to VAS (77.4±7.2 and 76.7±7.7, respectively) – p>0.05. In turn, pain syndrome on days 1 and 5 (47.6±5.1 versus 69.4±4.9 and 32.1±6.2 versus 51.4±5.8, respectively) after surgery in patients of the main group was statistically lower than in patients of the comparison group – p≤0.05, however, by day 30, this difference leveled out. No complications were identified during the observation period.
Conclusion. The obtained results demonstrated that the use of anterior approach for hip arthroplasty contributes to the development of less pain in the early postoperative period in comparison with the use of the anterolateral approach, however, by 1 month after the operation, this difference is leveled.
Keywords: hip arthroplasty, treatment of coxarthrosis, anterior approach, minimally invasive approach.
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