Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: The direct superior approach (DSA) is a modification of the posterior approach (PA) that is intended to preserve the iliotibial band and short external rotators, except for the piriformis and conjoined tendon, during total hip arthroplasty (THA). The objective of this study was to compare postoperative pain scores between patients undergoing the DSA versus the PA for THA.
Methods: This study included 80 patients with symptomatic hip arthritis undergoing primary THA. Patients were prospectively randomized to receive either the DSA or PA for THA. Surgery was undertaken using identical implant designs in both groups, and all patients underwent a standardized postoperative rehabilitation program. Predefined study outcomes were recorded by blinded observers at regular intervals for 2 years after THA.
Results: Patients in the PA and DSA groups had comparable baseline characteristics for age (mean and standard deviation, 67.3 ± 7.4 and 67.8 ± 7.8 years, respectively; p = 0.962), sex (26 male and 14 female patients, and 21 male and 19 female patients, respectively; p = 0.499) and body mass index (29.0 ± 4.3 and 29.1 ± 5.3 kg/m 2 ; respectively; p = 0.298). There was no significant difference between the PA and DSA groups with respect to postoperative pain scores at 24 hours as assessed using the visual analogue scale (4.5 ± 1.2 and 4.2 ± 2.0, respectively; p = 0.312). The overall time to hospital discharge was 43.6 ± 9.7 hours in the PA group and 45.4 ± 8.9 hours in the DSA group. Two patients in the PA group and 1 in the DSA group developed superficial wound infections, which were successfully treated with oral antibiotics. There were no further complications or harm sustained by patients in either treatment group.
Conclusions: This study showed that the intended benefits of the DSA in preserving the iliotibial band and the short external rotators, except for the piriformis and conjoined tendon, did not translate to any difference in postoperative pain scores when compared with the PA for THA.
Level Of Evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2106/JBJS.24.00830 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Perceptions of patients and health care professionals on postoperative pain management: Key factors influencing persistent opioid use.
Br J Health Psychol
September 2025
Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK.
Objective: This study applied the Theoretical Domains Framework (TDF) to explore the barriers and enablers to optimizing post-operative pain management and supporting safe opioid use from the perspectives of both patients and health care professionals, applying the Theoretical Domains Framework (TDF).
Design: Experience-based co-design (EBCD) qualitative study.
Methods: In the initial phase of the EBCD approach, focus groups were conducted comprising 20 participants, including 8 patients and 12 health care professionals involved in post-operative care.
Progressive Vision Loss From Uveal Melanoma with Extraocular Extension: A Case Report.
Am J Case Rep
September 2025
Department of Ophthalmology, Brasília University Hospital, Brasília, DF, Brazil.
BACKGROUND Uveal melanoma is the most common primary intraocular malignancy in adults, often diagnosed late in resource-limited settings. The diagnosis is made through a combination of clinical ophthalmologic examination, B-mode ultrasound, and histopathological study. This report details a case of a 67-year-old woman with progressive vision loss and ocular pain due to an inferomedial uveal melanoma to highlight therapeutic limitations from delayed diagnosis.
View Article and Find Full Text PDFMinimally invasive surgical approaches for pneumothorax: evolution and current perspectives.
Expert Rev Respir Med
September 2025
Department of General Thoracic Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino Hospital, Chiba, Japan.
Introduction: PubMed was used for a literature search (1990-2025) on the minimally invasive surgical approaches for pneumothorax, which have evolved markedly, with video-assisted thoracic surgery (VATS) emerging as a preferred procedure. Systematic reviews of randomized control trials indicate that VATS is less invasive than traditional thoracotomy. Furthermore, uniportal VATS provides less postoperative pain and better cosmetic outcomes than thoracotomy.
View Article and Find Full Text PDFReimagining Outcomes: A Perspective Review of Advances in Remote Monitoring Technologies in Post-Arthroplasty Patient Care.
J Orthop Res
September 2025
Department of Kinesiology, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA.
Arthroplasty surgery is a common and successful end-stage intervention for advanced osteoarthritis. Yet, postoperative outcomes vary significantly among patients, leading to a plethora of measures and associated measurement approaches to monitor patient outcomes. Traditional approaches rely heavily on patient-reported outcome measures (PROMs), which are widely used, but often lack sensitivity to detect function changes (e.
View Article and Find Full Text PDFDo elevated intrarenal pressures during mini percutaneous nephrolithotomy increase postoperative pain??
Urolithiasis
September 2025
Department of Urology, Icahn School of Medicine at Mount Sinai, 424 W. 59th Street, Suite 4F, New York, 10019, United States.
Introduction: High intrarenal pressures (IRP) during mini-PCNL have been postulated to result in increased postoperative pain but no studies have evaluated this to our knowledge. We sought to determine if there is a correlation between IRP and immediate postoperative pain when using different tract sizes.
Methods: Patients were enrolled and assigned for standard (s-PCNL, 24fr), suctioning-mini (sm-PCNL, 16fr) and non-suctioning-mini (nsm-PCNL, 17.