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Selection of a surgical approach for total hip arthroplasty according to the depth to the surgical site

Selection of a surgical approach for total hip arthroplasty according to the depth to the surgical site

Hip Int 2017; 27(3): 273 - 280

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/hipint.5000463

Authors

Takaaki Ohmori, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Hiroyuki Tsuchiya

Abstract

Background

The surgical depths of approaches for total hip arthroplasty (THA) have not been reported previously. In this study, we investigate the relationships between the distances to the centre of the femoral head in different approaches and body mass index (BMI).

Methods

The study included patients with normal hip joints who presented to our hospital. We used the pelvic coordinate system relative to the anterior pelvic plane and the femur coordinate system relative to the posterior condylar plane. We assessed the anterior, anterolateral, lateral and posterior approaches, and defined each approach line. We evaluated each distance in terms of BMI and gender.

Results

164 hips were assessed. The distance to the centre of the femoral head was the longest in the posterior approach, followed by the lateral, anterolateral, and anterior approaches (p<0.05). Additionally, the distance in each approach increased as patients’ BMI increased. The approximated line tilts were almost the same. The correlation coefficients between BMI and the distance to the centre of the femoral head were high in all approaches. In the anterior and anterolateral approaches, men with low BMI had a short distance to the femoral head. The distance for each approach was measured according to the pelvic coordinate system and the femur coordinate system. The results showed no significant differences between them.

Conclusions

The distance to the centre of the femoral head is the shortest in the anterior approach, regardless of BMI and gender. The distance in each approach might increase with an increase in BMI. BMI has similar effects in all approaches.

Article History

Disclosures

Financial support: None.
Conflicts of interest: None.

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Authors

Affiliations

  • Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa - Japan
  • Department of Orthopaedic Surgery, Kanazawa Red Cross Hospital, Kanazawa - Japan

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