General vs Spinal Anesthesia for Total Joint Arthroplasty-Anterior Approach: A Single-Institution Observational Study

The study compares the effects of various anesthetic techniques on anterior approach total hip arthroplasty results retrospectively

Study Overview

• Status: Completed
• Conditions: Anesthesia; Arthroplasty Complications
• Intervention / Treatment: Procedure: Total Hip Arthroplasty; Procedure: General Anesthesia; Procedure: Spinal Anesthesia

Detailed Description

Under general (GA) or spinal anesthesia (SA), total hip arthroplasty using the anterior approach (THA-A) can be safely performed. The best method is not sufficiently described in the literature currently in existence.This observational study was carried out at a single facility with consecutive enrollment of patients getting primary THA-A. The investigators compared the difference in complication rates, intraoperative blood loss, length of hospital stay, and duration of surgery, acetabular and femoral component orientation and stem subsidence.

• Study Type: Observational
• Enrollment (Actual): 437

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34140
    • Bezmialem Vakif University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Probability Sample

Study Population

- patients who underwent direct anterior approach primary total hip arhtroplasty with hip osteoarthritis

Description

Inclusion Criteria:

• patients who underwent direct anterior approach primary total hip arthroplasty with general anesthesia
• patients who underwent direct anterior approach primary total hip arthroplasty with spinal anesthesia

Exclusion Criteria:

• patients who underwent revision total hip arthroplasty
• patients who underwent total hip arthroplasty with approaches other than direct anterior approach
• patients who underwent primary total hip arthroplasty due to hip fractures

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
General Anesthesia Group; The group that underwent direct anterior total hip arthroplasty with general-systemic anesthesia	Procedure: Total Hip Arthroplasty; Patients that underwent direct anterior approach total hip arthroplasty; Procedure: General Anesthesia; Patients that underwent general/systemic anesthesia before surgery
Spinal Anesthesia Group; The group that underwent direct anterior total hip arthroplasty with spinal-neuraxial anesthesia	Procedure: Total Hip Arthroplasty; Patients that underwent direct anterior approach total hip arthroplasty; Procedure: Spinal Anesthesia; Patients that underwent spinal/neuraxial anesthesia before surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean intraoperative estimated blood loss	Total blood volume was calculates according to Nadler's formula based on patient's sex, height and weight of the patient, whereas the estimated blood loss was calculated according to Meunier's formula (mL)	from preoperative session to postoperative 1 day
mean duration of surgery	Duration of total hip arthroplasty surgery for each patient	from preoperative session to postoperative 1 day
length of hospital stay	from date of operation until the date of discharge	from the date of total hip arthroplasty operation until the day that patients discharge, assesed up to 7 days
stem subsidence	Subsidence was evaluated by comparing immediate post-operative radiographic images with those obtained at 1 year follow-up. Subsidence was measured as a vertical drop of stem, characterised by a radiolucent line at the proximal most aspect of the bone-prosthesis interface.	postoperative 1 year
stem varus/valgus degrees	varus or valgus angulation of femoral stem after surgery	postoperative 1 year
acetabular abduction	abduction degree of acetabular component after surgery	postoperative 1 year

Collaborators and Investigators

• Sponsor: Bezmialem Vakif University

Study record dates

Study Major Dates

• Study Start (Actual): January 10, 2014
• Primary Completion (Actual): January 10, 2017
• Study Completion (Actual): May 25, 2017

Study Registration Dates

• First Submitted: February 12, 2024
• First Submitted That Met QC Criteria: March 19, 2024
• First Posted (Actual): March 20, 2024

Study Record Updates

• Last Update Posted (Actual): March 20, 2024
• Last Update Submitted That Met QC Criteria: March 19, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: total hip arthroplasty; general anesthesia; spinal anesthesia; direct anterior approach
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics
• Other Study ID Numbers: BezmialemVU 1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No