Posterolateral vs Direct Anterior Approach in Total Hip Arthroplasty (POLADA Trial): A Randomized Controlled Trial to Assess Differences in Serum Markers

Kyrill Rykov*, Inge H. F. Reininga, Maurits S. Sietsma, Bas A. S. Knobben, Bas L. E. F. ten Have

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)

Abstract

Background: The direct anterior approach (DAA) for total hip arthroplasty has claimed to be a true tissue-sparing minimally invasive approach that has less tissue damage and a faster recovery when compared to the posterolateral approach (PLA). The aim of this randomized controlled trial is to measure the differences in serum markers and functional outcomes between the DAA and PLA for total hip arthroplasty.

Methods: Forty-six patients were prospectively included and randomized for either the DAA (n = 23) or PLA (n = 23). All surgical procedures were performed by 3 well-trained orthopedic surgeons. The degree of tissue damage was assessed by measuring creatine kinase (CK) and C-reactive protein levels (CRP) preoperatively and 2 hours, 1 day, 2 weeks, and 6 weeks postoperatively. Generalized linear mixed models analyses were used to assess differences between serum markers over time; correction for possible confounding factors was performed. The Hip disability and Osteoarthritis Outcome Score and the Harris Hip Score were assessed preoperatively and 6 weeks postoperatively.

Results: There were no differences in patient demographics. The DAA had a longer operative time (P = .001). CK and CRP levels increased postoperatively, but no significant differences between the groups were found on any of the time points. Functional outcomes were also similar in both approaches.

Conclusion: No difference in tissue damage measured with serum markers CK and CRP were found between the DAA and PLA for total hip arthroplasty.

Original languageEnglish
Pages (from-to)3652-36587.e1
Number of pages8
JournalJournal of Arthroplasty
Volume32
Issue number12
DOIs
Publication statusPublished - Dec-2017

Keywords

  • direct anterior approach
  • posterolateral approach
  • creatine kinase
  • C-reactive protein
  • functional outcomes
  • serum markers
  • C-REACTIVE PROTEIN
  • INVASIVE DIRECT ANTERIOR
  • DIRECT LATERAL APPROACH
  • MUSCLE DAMAGE
  • LEARNING-CURVE
  • REPLACEMENT
  • INFLAMMATION
  • OUTCOMES
  • SURGERY
  • TRAUMA

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