POSTERIOR APPROACH TOTAL HIP REPLACEMENT TO SPARE PIRIFORMIS MUSCLE: A STUDY AT A TERTIARY CARE HOSPITAL
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Keywords
Piriformis Muscle, Total Hip Arthroplasty, Oxford hip Ratio
Abstract
OBJECTIVE: The purpose of this study is to assess the functional result in terms of hip function and postoperative pain of patients who underwent total hip replacement surgery utilizing a technique that spared the piriformis muscle.
BACKGROUND: Several methods to the hip joint have been advocatedfor the total hip arthroplasty (THA) including direct anterior, anterolateral, lateral, posterior, and posterolateral approaches. Because of its benefits, the posterolateral technique is widely used, which include sufficient exposure of femur and acetabular fossa and abductor muscle preservation in THA. Comparatively the lesser invasive methods have been used to lessen the dislocation rates because of maintaining the piriformis muscle. Studies have found that maintaining the piriformis was beneficial.
STUDY DESIGN: cohort study
PLACE AND DURATION: This study was conducted in Mastoi Medicare Centre Nawabshah from December 2022 to December 2023
METHODOGY: The Oxford Hip Scale, which consists of 12 items with a total score of 48 (X1) and a score ranging from 0 to 4, as well as the 12-item Short Form Survey (SF-12) general health score, were utilized to assess the hips' functioning. It is divided into two sections. SPSS version 26 was utilized for data entry and analysis. P-values were deemed statistically significant if they were less than 0.05. The numerical data was presented using mean ± SD, whereas the categorical variables were reported using frequencies and percentages.
RESULTS: The procedure involved 24(44.44%) patients with left hip surgery and 30(55.56%) patients with right hips surgery. Surgerywasperformedonleftsidein26patientsandrightsidein 34 patients. The most common indication for surgery wasOA in 44 (81.48%) followed by other causes in 7(12.96%) patients. There were 24(44.44%) and 30(55.56%) patients able to walk with and without the support respectively, there were 46 (85.19%) patients and 7(14.81%) patients in PM grade 0 and I respectively.
CONCLUSION: When it comes to hip replacement surgery, the posterior approach that spares the Piriformis muscle provides a better functional outcome in terms of hip function and postoperative pain. Piriformis muscle is particularly crucial hence it should be spared wherever feasible to have the greatest results following total hip replacement using posterior approach.
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Sundas Mastoi
Consultant Orthopaedics Surgeon, Peoples University of Medical and Health Sciences Nawabshah Pakistan
Zimyad Ali Mastoi
Consultant Orthopaedics Surgeon, Peoples University of Medical and Health Sciences Nawabshah Pakistan.
Muhammad Shuaib Chandio
Assistant Professor Orthopaedics, Shaheed Muhtarama Benazir Bhutto Medical University Larkana Pakistan
Hussain Bux Palh
Assistant Professor Orthopaedics, Gambat Medical College, Pir Syed Abdul Qadir Shah Jeelani Institute of Medical Science GIMS Gambat Pakistan.
Najeeb u Rehman
Assistant Professor Orthopaedics, Peoples University of Medical and Health Sciences Nawabshah Pakistan. email:
Abdul Rasheed
Associate Professor Orthopaedic Surgery, Khairpur Medical College Khairpur mir’s Pakistan.