Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
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Purpose
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Leg length discrepancy (LLD) is a common complication following total hip arthroplasty (THA). The direct anterior approach (DAA) for THA is gaining popularity due to its advantages, but there is limited research on the incidence and size of LLD. This systematic review aims to explore the differences in LLD between DAA and other approaches, as well as the techniques to control LLD in DAA.
Methods
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A comprehensive literature search was conducted to identify relevant studies comparing THA by DAA with other surgical approaches and investigating methods to control LLD in DAA, following PRISMA guidelines and a priori registration on PROSPERO (CRD42023412644). The quality of the included studies was assessed. Data on preoperative and postoperative LLD and other relevant outcomes were extracted and analyzed descriptively.
Results
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In total, 29 studies were included in this systematic review. The majority (86%) were classified as level IV evidence. Comparisons between DAA and posterior approach (PA) or anterolateral approach (ALA) showed DAA had lower rates of LLD >10 mm compared to PA and ALA. Different pre- and intra-operative techniques were evaluated, but no consensus on the best method for preventing LLD in DAA was reached.
Conclusion
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DAA shows comparable or superior results in the prevention of LLD compared to other surgical approaches. Supine patient placement, direct leg measurement, and the use of IF contribute to these outcomes. Intraoperative fluoroscopy with a grid and preoperative planning offers a good option, especially for training purposes, but its role in preventing LLD by experienced DAA surgeons needs further investigation.
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Division of Spine Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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He DW Zhao X Ma WH Ni WF Song YX Zhang JQ Yu W Fang XQ et al . Complications and prevention strategies of oblique lateral interbody fusion technique . Orthopaedic Surgery 2018 10 98 – 106 . ( https://doi.org/10.1111/os.12380 ) 25
Hospital Militar de Santiago, Santiago, Chile
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Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
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. Regardless of the type of fracture, prevention is always preferable to treatment. Knowing predisposing factors – such as making a medial opening > 11 mm – is essential. Applying prevention strategies such as preserving at least a 5–10 mm distance from the
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restore motion, muscle strength and function. Regular exercise, fall-prevention strategies, and optimization of calcium and vitamin D intake are all recommended for further fracture prevention. 18 Pseudotumours Starker described this
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comparison was done looking at the cost and benefits of three SSI prevention strategies: the SOC, ‘test and treat’ and ‘treat all’ ( 78 ). A financial model was then used to show that the treat-all strategy prevented the most SSIs and resulted in the lowest
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commercial party related directly or indirectly to the subject of this article. References 1 Griffin LY , Agel J , Albohm MJ , et al. . Noncontact anterior cruciate ligament injuries: risk factors and prevention
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Mimetis Biomaterials, Spain
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the stabilization of the apatite phase in enamel (which proved to be an effective prevention strategy for tooth decay). More recently, other ions have attracted a great deal of attention due to their specific biological effects. This has fostered not
