Journal article
Capsular Management in Direct Anterior Total Hip Arthroplasty: A Randomized, Single-Blind, Controlled Trial
The Journal of arthroplasty, Vol.36(8), pp.2836-2842
08/01/2021
DOI: 10.1016/j.arth.2021.03.048
PMID: 33865648
Abstract
Background: The direct anterior approach (DAA) is a popular approach to total hip arthroplasty (THA). Unlike the posterior approach, the importance of anterior capsular management is unknown. This randomized controlled trial compares capsular repair versus capsulectomy.
Methods: This single-surgeon, single-blinded, parallel-group randomized controlled trial occurred between 2013 and 2016. Patients undergoing unilateral, primary THA for osteoarthritis consented to undergo blinded, simple randomization to anterior capsulotomy with repair or anterior capsulectomy. Primary outcome measures included hip range of motion, hip flexion strength, and pain with seated hip flexion. Secondary outcome measures included surgical time, estimated blood loss, postoperative complications, and hip disability and osteoarthritis outcome score. Data were prospectively collected intraoperatively, six weeks, six months, an average of over 5 years postoperatively.
Results: Ninety-eight patients were ultimately enrolled in the trial; 50 received capsulectomy and 48 received capsulotomy. No significant differences were seen in preoperative demographics or in primary or secondary outcomes during this study. No difference was seen in pain at final follow-up at average > 5 years postoperatively.
Conclusion: This study demonstrates that capsular management in DAA THA does not affect postoperative pain or range of motion. The anterior capsule's role in prosthetic stability after DAA THA remains uncertain, but it does not currently appear that repair provides benefit and may lead to increased surgical time and blood loss. As such, capsular management in DAA THA is at surgeon discretion. (C) 2021 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Capsular Management in Direct Anterior Total Hip Arthroplasty: A Randomized, Single-Blind, Controlled Trial
- Creators
- Andrew M. Schwartz - Department of Orthopaedic Surgery, Atlanta, GA.Rahul K. Goel - Department of Orthopaedic Surgery, Atlanta, GA.Aidan P. Sweeney - Department of Orthopaedic Surgery, Atlanta, GA.Thomas L. Bradbury - Department of Orthopaedic Surgery, Atlanta, GA.
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.36(8), pp.2836-2842
- Publisher
- Elsevier
- DOI
- 10.1016/j.arth.2021.03.048
- PMID
- 33865648
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303974002771
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