REVIEW ARTICLE


Muscle Damage in Different Approaches in Total Hip Arthroplasty According to Serum Markers



Stylianos Tottas1, *, Aliki Fiska2, Ioannis Kougioumtzis1, Athanasios Ververidis1, Konstantinos Tilkeridis1, Georgios I Drosos1
1 Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece
2 Department of Anatomy, Medical School, Democritus University of Thrace, Dragana, 68100, Alexandroupolis, Greece


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Creative Commons License
© 2019 Tottas et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, St. Niarhos Street 1, Dragana, 68100 Alexandroupolis, Greece;Tel: +30-255-1352209; E-mail: stottasdoc@hotmail.com.


Abstract

Background:

Total Hip Arthroplasty (THA) is the final treatment of end-stage hip osteoarthritis. Nowadays, THA has become very common, cost- effective and one of the most successful orthopaedic procedures. Recently, surgeons have shifted their interest to approaches according to Minimally Invasive Surgery (MIS). These approaches are either modifications of conventional approaches or they are designed from the beginning as MIS approaches. Muscle damage and soft tissue damage are issues that concern researchers who perform studies on THA.

Objective:

The aim of this study is to review the literature concerning studies by comparing different approaches using serum and inflammatory markers for muscle and soft tissue damage.

Methods:

We searched the PubMed database in the English language systematically for clinical studies or reviews, comparing muscle damage according to serum markers between two or more approaches in primary total arthroplasty.

Results:

In total, twenty-one studies were included in this review. Although the results are controversial, it seems that MIS approaches in most of the studies were related to lower levels of inflammation markers contrasting with conventional approaches. Nevertheless, this difference in muscle damage is not correlated with a difference in functional scores or other perioperative data and clinical outcomes in all studies.

Conclusion:

The existing literature does not lead to a safe consensus about the superiority of any approach. Therefore, there is still a need for further research with well-designed studies.

Keywords: Approach, Inflammatory markers, Muscle damage, Serum markers, Total hip arthroplasty, Total hip replacement.