|Outcomes in obese patients undergoing direct anterior hip replacement: a nonrandomized study
Sophia Stasi, Dimitrios Tzefronis, George Papathanasiou, Michail Sarantis, George A Macheras
April-June 2020, 5(2):25-30
Background and objective: In recent years, there has been growing interest in the minimally invasive surgical techniques used for the performance of total hip arthroplasty (THA). Among these, direct anterior approach–minimally invasive surgery (DAA-MIS) has generated scientific interest because of its soft-tissue–preserving nature. Data from studies involving obese patients in relation to minimally invasive techniques such as DAA-MIS are controversial, while further comparative studies are needed between nonobese and obese patients. The aim of this study was to compare pain levels, functionality and quality of life between obese and nonobese hip osteoarthritic patients who underwent THA via DAA-MIS.
Subjects and methods: This nonrandomized study included 60 patients aged > 50 years. Patients were divided into two equal groups according to their body mass index (< 30 kg/m2 vs. ≥ 30 kg/m2). Measurements were recorded prior to surgery and postoperatively (6th and 12th weeks). Pain was measured using the Face Pain Scale–Revised. Functionality was measured with the Timed Up & Go test and the modified Harris Hip Score-Greek version. Quality of life was evaluated using the 12-item International Hip Outcome Tool–Greek version. The protocol of this study was approved by both the Ethics Committee and Scientific Research Council of the “KAT” General Hospital of Attica, Athens, Greece (ref: ΔΣ234/12-03-2019) on March 12, 2019.
Results: Six weeks after DAA-MIS, both obese and nonobese patients had significantly less pain (Face Pain Scale-Revised), higher functionality (Timed Up & Go test and modified Harris Hip Score-Greek version) and better quality of life (12-item International Hip Outcome Tool–Greek version), compared to preoperative measurements (P < 0.001). The improvement in all overall outcomes continued, with a further statistically significant difference in the 12th week’s measurements (P < 0.001). There were no statistically significant differences between groups at the 6th and 12th postoperative weeks (P > 0.05).
Conclusion: Both obese and nonobese patients benefited from the DAA-MIS procedure. The obesity should not be considered as a contraindication to DAA-MIS in patients undergoing THA.
Trial registration: This study analyzes part of data collected for an ongoing larger trial [World Health Organization’s International Clinical Trials Registry Platform (ISRCTN15066737)].
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