@article{ReichertvonRottkayRothetal.2018, author = {Reichert, Johannes C. and von Rottkay, Eberhard and Roth, Franz and Renz, Tim and Hausmann, Johannes and Kranz, Julius and Rackwitz, Lars and N{\"o}th, Ulrich and Rudert, Maximilian}, title = {A prospective randomized comparison of the minimally invasive direct anterior and the transgluteal approach for primary total hip arthroplasty}, series = {BMC Musculoskeletal Disorders}, volume = {19}, journal = {BMC Musculoskeletal Disorders}, number = {241}, doi = {10.1186/s12891-018-2133-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176072}, year = {2018}, abstract = {Background: The presented prospective randomized controlled single-centre study compares the clinical outcome up to 12 months after total hip arthroplasty using a minimally invasive single-incision direct anterior (DAA) and a direct transgluteal lateral approach. Methods: A total of 123 arthroplasties were evaluated utilizing the Harris Hip Score (HHS), the extra short musculoskeletal functional assessment questionnaire (XSFMA), the Short Form 36 (SF-36) health survey, a Stepwatch™ Activity Monitor (SAM), and a timed 25 m foot walk (T25-FW). Postoperative x-ray images after THA were reviewed to determine inclination and stem positioning. Results: At final follow-up, the XSFMA functional index scores were 10.3 (anterior) and 15.08 (lateral) while the bother index summed up to a score of 15.8 (anterior) and 21.66 (lateral) respectively, thus only differing significantly for the functional index (p = 0.040 and p = 0.056). The SF-36 physical component score (PCS) was 47.49 (anterior) and 42.91 (lateral) while the mental component score (MCS) summed up to 55.0 (anterior) and 56.23 (lateral) with a significant difference evident for the PCS (p = 0.017; p = 0.714). Patients undergoing THA through a DAA undertook a mean of 6402 cycles per day while those who had undergone THA through a transgluteal approach undertook a mean of 5340 cycles per day (p = 0.012). Furthermore, the obtained outcome for the T25-FW with 18.4 s (anterior) and 19.75 s (lateral) and the maximum walking distance (5932 m and 5125 m) differed significantly (p = 0.046 and p = 0.045). The average HHS showed no significant difference equaling 92.4 points in the anterior group and 91.43 in the lateral group (p = 0.477). The radiographic analysis revealed an average cup inclination of 38.6° (anterior) and 40.28° (lateral) without signs of migration. Conclusion: In summary, our outcomes show that after 1 year THA through the direct anterior approach results in a higher patient activity compared to THA utilizing a transgluteal lateral approach while no differences regarding hip function are evident.}, language = {en} } @article{StratosHellerRudert2022, author = {Stratos, Ioannis and Heller, Karl-Dieter and Rudert, Maximilian}, title = {German surgeons' technical preferences for performing total hip arthroplasties: a survey from the National Endoprosthesis Society}, series = {International Orthopaedics}, volume = {46}, journal = {International Orthopaedics}, number = {4}, doi = {10.1007/s00264-021-05188-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266350}, pages = {733-739}, year = {2022}, abstract = {Purpose The goal of our study was to conduct an online survey that highlights patterns of practice during total hip arthroplasty (THA). Methods The survey was conducted in June and August 2020. Three hundred thirteen members of the German Society for Endoprosthesis participated in the survey. Results The anterolateral approach is by far the most popular approach used for primary total hip arthroplasty, followed by the anterior approach during minimally invasive (55\% for the anterolateral and 29\% for the anterior) and regular surgery (52\% for the anterolateral and 20\% for the anterior). Two-thirds of the orthopaedic surgeons do not use drainages during THA. Moreover, 80\% of the survey participants routinely apply tranexamic acid during surgery. Surgeons who perform minimally invasive surgery for THA use more frequently fast-track-concepts for post-operative rehabilitation. According to the interviewees, the application of fast-track-concepts leads to reduced periods of hospital stay after THA. Conclusion Our data demonstrate that patterns of practice during THA in Germany are in line with the evidence provided by current literature. This study can be seen as a stimulus to conduct similar surveys in other countries in order to promote minimally invasive surgery for THA.}, language = {en} } @article{ArnholdtGilbertBlanketal.2017, author = {Arnholdt, J{\"o}rg and Gilbert, Fabian and Blank, Marc and Papazoglou, Jannis and Rudert, Maximilian and N{\"o}th, Ulrich and Steinert, Andre F.}, title = {The Mayo conservative hip: complication analysis and management of the first 41 cases performed at a University level 1 department}, series = {BMC Muskoskeletal Disorders}, volume = {18}, journal = {BMC Muskoskeletal Disorders}, number = {250}, doi = {10.1186/s12891-017-1613-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157812}, year = {2017}, abstract = {Background: To prevent bone loss in hip arthroplasty, several short stem systems have been developed, including the Mayo conservative hip system. While there is a plethora of data confirming inherent advantages of these systems, only little is known about potential complications, especially when surgeons start to use these systems. Methods: In this study, we present a retrospective analysis of the patients' outcome, complications and the complication management of the first 41 Mayo conservative hips performed in 37 patients. For this reason, functional scores, radiographic analyses, peri- and postoperative complications were assessed at an average follow-up of 35 months. Results: The overall HHS improved from 61.2 pre-operatively to 85.6 post-operatively. The German Extra Short Musculoskeletal Function Assessment Questionnaire (XSFMA-D) improved from 30.3 pre-operatively to 12.2 post-operatively. The most common complication was an intraoperative non-displaced fracture of the proximal femur observed in 5 cases (12.1\%). Diabetes, higher BMI and older ages were shown to be risk factors for these intra-operative periprosthetic fractures (p < 0.01). Radiographic analysis revealed a good offset reconstruction in all cases. Conclusion: In our series, a high complication rate with 12.1\% of non-displaced proximal femoral fractures was observed using the Mayo conservative hip. This may be attributed to the flat learning curve of the system or the inherent patient characteristics of the presented cohort."}, language = {en} }