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Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement
- Source :
- Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders, Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, Vol 14 (2021)
- Publication Year :
- 2021
-
Abstract
- Purpose: Muscle-sparing approaches for total hip replacement (THR) involve learning curves. This study aimed to clarify changes in invasiveness and infection rate with changes in approach. Methods: One surgeon changed the approach of THR from Dall’s approach (Dall) to anterolateral modified Watson-Jones approach (OCM). Another changed from Dall to a direct anterior approach (DAA). Another 3 surgeons changed from posterolateral approach (PL) to OCM. Subjects were 150 cases, comprising the last 25 cases with conventional approaches and the first 25 cases with new approaches (Dall to OCM: 25 + 25; Dall to DAA: 25 + 25; PL to OCM: 25 + 25 cases). Differences in operative time, bleeding volume, hospital stay, haemoglobin (Hb), white blood cell count, lymphocyte count, creatine kinase (CK) and C-reactive protein (CRP) were investigated. Results: In the change from Dall to OCM, only hospital stay decreased. In the change from Dall to DAA, hospital stay and CRP decreased, but bleeding volume increased. In the change from PL to OCM, operative time, CRP and CK decreased, but Hb also decreased. Cases with lymphocyte count Conclusion: Introducing muscle-sparing approaches improved many markers of invasiveness, but some items deteriorated. In the early stages of introducing a new approach, choosing cases without obesity and without high muscle volume may reduce the risk of infection.
- Subjects :
- medicine.medical_specialty
Lymphocyte
invasiveness
Total hip replacement
Urology
infection rate
Diseases of the musculoskeletal system
Muscle volume
03 medical and health sciences
0302 clinical medicine
Rheumatology
White blood cell
Immunology and Allergy
Medicine
030212 general & internal medicine
Original Research
030222 orthopedics
biology
surgical approach
business.industry
Infection rate
medicine.anatomical_structure
learning curve
RC925-935
biology.protein
Operative time
Creatine kinase
sense organs
business
Posterolateral approach
Subjects
Details
- ISSN :
- 11795441
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Clinical medicine insights. Arthritis and musculoskeletal disorders
- Accession number :
- edsair.doi.dedup.....e0359a524e0822daf506dbb9457eb287