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MINERVA ORTOPEDICA E TRAUMATOLOGICA
Rivista di Ortopedia e Traumatologia
Minerva Ortopedica e Traumatologica 2014 June;65(3):207-10
Cost-effective comparison between anterior and posterolateral approach in total hip arthroplasty
Bonani A. 1, Giachino M. 1, Aprato A. 2, Massè A. 2 ✉
1 Faculty of Medicine and Surgery, University of Turin, Turin, Italy;
2 Department of Orthopedic Surgery, S. Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
AIM: The most worldwide practiced approach for total hip arthroplasty (THA) is the postero-lateral approach but recently the direct anterior approach gained popularity. This study presents a cost-effective analysis of the direct anterior versus posterolateral approach in THA, considering both monolateral and bilateral procedures.
METHODS: Patients treated with primary THA were included in this retrospective study and classified in four different populations: one stage bilateral anterior THA (group AB1: 6 patients), monolateral anterior THA (group AM: 17 patients), two stage bilateral posterior THA (group PB2: 23 patients) and monolateral posterior THA (PM: 102 patients). Groups were compared in terms of age, total length of hospitalization, homologous blood transfusions and operative time. Functional outcomes were assessed using the WOMAC Score at the last follow up. When the procedure was performed in two stages, length of hospitalization, number of lost working days, homologous blood transfusions and operative time of two hospitalizations were summarized.
RESULTS: Differences in length of hospitalization were significant (P-value 0.0009) between group AB1 and PB2. No other significant differences were found between those two groups. No significant differences were found between group AM and PM but mean operative time was significantly longer for the anterior than posterior approach (P-value 0.001).
CONCLUSION: Our results support the use of one stage bilateral anterior THA when a bilateral THA for the reduce length of hospitalization and costs. On the other hand we found no difference between anterior and posterior approach when a single side THA is performed a part from a longer surgical time for anterior approach.