Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement

Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement

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-J...

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Veröffentlicht in:Clinical medicine insights. Arthritis and musculoskeletal disorders 2021, Vol.14, p.11795441211031340-11795441211031340
Hauptverfasser: Kijima, Hiroaki, Tateda, Kenji, Yamada, Shin, Nagoya, Satoshi, Fujii, Masashi, Kosukegawa, Ima, Kawano, Tetsuya, Miyakoshi, Naohisa, Yamashita, Toshihiko, Shimada, Yoichi
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container_title Clinical medicine insights. Arthritis and musculoskeletal disorders
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creator Kijima, Hiroaki
Tateda, Kenji
Yamada, Shin
Nagoya, Satoshi
Fujii, Masashi
Kosukegawa, Ima
Kawano, Tetsuya
Miyakoshi, Naohisa
Yamashita, Toshihiko
Shimada, Yoichi
description 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
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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 &lt;1000/μL or lymphocytes comprising &lt;10% of total white blood cells at around day 4 after surgery were defined as latent infection cases. In these cases, operative time was longer, Hb was lower and CK was higher. 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.</description><identifier>ISSN: 1179-5441</identifier><identifier>EISSN: 1179-5441</identifier><identifier>DOI: 10.1177/11795441211031340</identifier><identifier>PMID: 34345193</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Infections ; Original Research</subject><ispartof>Clinical medicine insights. Arthritis and musculoskeletal disorders, 2021, Vol.14, p.11795441211031340-11795441211031340</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021 2021 SAGE Publications Ltd unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c395t-2ee81157b415bdc1cc0735c823b32187b96d124b881bdc799207442259a46bb13</cites><orcidid>0000-0003-4939-9545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280835/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280835/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,4010,21945,27830,27900,27901,27902,44921,45309,53766,53768</link.rule.ids></links><search><creatorcontrib>Kijima, Hiroaki</creatorcontrib><creatorcontrib>Tateda, Kenji</creatorcontrib><creatorcontrib>Yamada, Shin</creatorcontrib><creatorcontrib>Nagoya, Satoshi</creatorcontrib><creatorcontrib>Fujii, Masashi</creatorcontrib><creatorcontrib>Kosukegawa, Ima</creatorcontrib><creatorcontrib>Kawano, Tetsuya</creatorcontrib><creatorcontrib>Miyakoshi, Naohisa</creatorcontrib><creatorcontrib>Yamashita, Toshihiko</creatorcontrib><creatorcontrib>Shimada, Yoichi</creatorcontrib><title>Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement</title><title>Clinical medicine insights. Arthritis and musculoskeletal disorders</title><description>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 &lt;1000/μL or lymphocytes comprising &lt;10% of total white blood cells at around day 4 after surgery were defined as latent infection cases. In these cases, operative time was longer, Hb was lower and CK was higher. Conclusion: Introducing muscle-sparing approaches improved many markers of invasiveness, but some items deteriorated. 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Arthritis and musculoskeletal disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kijima, Hiroaki</au><au>Tateda, Kenji</au><au>Yamada, Shin</au><au>Nagoya, Satoshi</au><au>Fujii, Masashi</au><au>Kosukegawa, Ima</au><au>Kawano, Tetsuya</au><au>Miyakoshi, Naohisa</au><au>Yamashita, Toshihiko</au><au>Shimada, Yoichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement</atitle><jtitle>Clinical medicine insights. Arthritis and musculoskeletal disorders</jtitle><date>2021</date><risdate>2021</risdate><volume>14</volume><spage>11795441211031340</spage><epage>11795441211031340</epage><pages>11795441211031340-11795441211031340</pages><issn>1179-5441</issn><eissn>1179-5441</eissn><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 &lt;1000/μL or lymphocytes comprising &lt;10% of total white blood cells at around day 4 after surgery were defined as latent infection cases. In these cases, operative time was longer, Hb was lower and CK was higher. 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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>34345193</pmid><doi>10.1177/11795441211031340</doi><orcidid>https://orcid.org/0000-0003-4939-9545</orcidid><oa>free_for_read</oa></addata></record>
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subjects Infections
Original Research
title Changes in Invasiveness and Latent Infection Rate Associated with Switching the Approach in Total Hip Replacement
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