Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial.
anterior hip replacement
direct anterior approach
muscle damage
physical therapy pain levels
total hip arthroplasty rehabilitation
Journal
Orthopedic reviews
ISSN: 2035-8237
Titre abrégé: Orthop Rev (Pavia)
Pays: United States
ID NLM: 101524779
Informations de publication
Date de publication:
22 Apr 2020
22 Apr 2020
Historique:
received:
01
12
2019
accepted:
14
02
2020
entrez:
12
5
2020
pubmed:
12
5
2020
medline:
12
5
2020
Statut:
epublish
Résumé
The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach's main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.
Identifiants
pubmed: 32391134
doi: 10.4081/or.2020.8399
pmc: PMC7206361
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8399Informations de copyright
©Copyright: the Author(s).
Déclaration de conflit d'intérêts
Conflict of interest: The authors declare no conflict of interest.
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