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Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study. | LitMetric

Superior Transverse Atraumatic Reconstruction (STAR) approach provides a better-compared outcome to standard Direct Superior Approach (DSA): a matched, prospective comparative single-surgeon study.

SICOT J

Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki 56403, Greece - Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, GR 57001, Greece - Tsiridis Orthopaedic Institute - ICAROS Clinic, Thessaloniki, Greece.

Published: April 2023

AI Article Synopsis

  • The Direct Superior Approach (DSA) for hip surgery has been modified into the STAR (Superior Transverse Atraumatic Reconstruction) approach, which aims to preserve important muscle structures while still providing similar benefits.
  • A study compared outcomes between 200 patients using the STAR approach and 200 patients using DSA, focusing on factors like incision length, hospital stay, and functional recovery.
  • Results showed that patients in the STAR group had shorter incisions, less time in the hospital, and better functional improvement after surgery compared to those in the DSA group, with both methods having low complication rates.

Article Abstract

Introduction: The Direct Superior Approach (DSA) is a muscle-sparing hip approach that does not protect the piriformis and the other short external rotators. We present a DSA modification we named STAR (Superior Transverse Atraumatic Reconstruction), which has DSA advantages but always preserves piriformis. Our study compared the early postoperative, radiological, and functional results of patients undergoing primary total hip arthroplasty (THA) through the STAR approach with a matched DSA group performed by a senior surgeon.

Methods: Each group, DSA, and STAR included 200 elective primary unilateral THAs performed by the surgeon between 2016-2017 and 2020-2021, respectively. Patients were included in both groups using the same inclusion criteria. Both groups were matched for age and sex. The same postoperative pain management, chemoprophylaxis, and physiotherapy protocols were followed in both groups. Two independent orthopaedic surgeons performed the clinical and radiological follow-up.

Results: The STAR group had significantly lower mean incision length (p = 0.042) and hospital stay (p = 0.002) than the DSA group. The mean intraoperative blood loss (p = 0.085) and the need for blood transfusion (p = 0.228) were less for the STAR than the DSA group. The mean postoperative functional scores improvement was significantly higher for the STAR than the DSA group at the end of the first and third postoperative months.

Conclusions: The STAR approach offers earlier functional improvement, shorter hospital stay and less transfusion need than DSA for patients undergoing primary THA. Both approaches showed a limited complication risk and an outstanding acetabular and femoral access enabling the procedure.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125016PMC
http://dx.doi.org/10.1051/sicotj/2023008DOI Listing

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