RESUMO
BACKGROUND: Despite the popularity of minimally invasive approaches in total hip arthroplasty, studies regarding their impact on soft tissues and long-term benefits are lacking. This study aims to compare the 10-year functional outcome of the piriformis-sparing minimally invasive approach to the standard posterior approach for total hip arthroplasty surgery. METHODS: Hundred patients were randomized, 48 patients to the piriformis-sparing approach and 52 to the standard approach. Primary outcomes were hip function and piriformis muscle volume and grade on magnetic resonance imaging. Secondary outcomes were pain, satisfaction score, and complications. Evaluators were blinded to allocation. Participants were followed up to 10 years. RESULTS: Ten years following surgery, both groups reported excellent pain relief, improved hip function, and high satisfaction. The significant differences were improvement in piriformis muscle volume (P = .001) and muscle grade (P = .007) in the piriformis-sparing group compared to the standard group. There were no significant differences in all other outcomes. CONCLUSION: Aside from being less injurious to the piriformis muscle, the piriformis-sparing approach offered the same long-term functional benefits as the standard posterior approach at 10 years.
Assuntos
Artroplastia de Quadril/estatística & dados numéricos , Tratamentos com Preservação do Órgão/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Feminino , Seguimentos , Quadril/cirurgia , Articulação do Quadril/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Músculo Esquelético , Osteoartrite do Quadril/cirurgia , Recuperação de Função FisiológicaRESUMO
Advanced imaging techniques such as computed tomography, ultrasound, and magnetic resonance imaging provide clinically useful information by detecting and characterizing pathologic conditions of the elbow. The information provided by these techniques can help establish an anatomic diagnosis in a noninvasive fashion. A timely and accurate imaging diagnosis may be an important piece of the puzzle in a diagnostic workup that allows implementation of proper treatment and improved outcome. In this article, the authors focus on recent advances in diagnostic imaging of the elbow joint.
