A research study on Piriformis Muscle Sparing Posterior Approach in Total Hip Replacement
Submission: 20 July 2024 | Acceptance: 25 September 2024 | Publication: 11 November 2024
1Kamran Chaudhary, 2Nouraiz Shakoor, 3Ahsan Ul haq Mohib Ali, 4Ayesha Bano, 5Mobeen Ali, 6Mohammed Akhtar Khan
1PIMS
2Senior Registrar Orthopaedics, Madinah Teaching Hospital Faisalabad
3Associate Professor, Orthopaedic Surgery, Mohterma Benazir Bhutto Shaheed Medical College Mirpur Azad Kashmir
4PIMS
5PIMS
6Consultant Surgeon/ Head of the Department of Orthopedics, NSHS SZABIST.
ABSTRACT:
Background: The piriformis muscle-sparing technique has been proposed to preserve biomechanical function and reduce complications. The posterior approach in total hip replacement (THR) is widely used; however, concerns about postoperative stability and muscle damage remain.
Aim: This study aimed to evaluate the clinical outcomes and biomechanical advantages of the piriformis muscle-sparing posterior approach in THR compared to the conventional posterior approach.
Methods: A comparative study was conducted at Services Hospital, Lahore, from October 2023 to September 2024. A total of 50 patients undergoing THR were included and divided into two groups: the piriformis-sparing approach (n=25) and the conventional posterior approach (n=25). Clinical outcomes were assessed using the Harris Hip Score (HHS) and postoperative pain levels. Biomechanical advantages, including gait analysis and hip stability, were also evaluated.
Results: Patients in the piriformis-sparing group demonstrated significantly higher HHS scores at three and six months postoperatively (p<0.05). Pain levels were lower in this group compared to the conventional approach. Gait analysis revealed improved hip stability, with a lower incidence of postoperative limp and dislocations. The preservation of the piriformis muscle contributed to enhanced early mobility and faster recovery.
Conclusion: The piriformis muscle-sparing posterior approach in THR resulted in superior clinical outcomes and biomechanical advantages compared to the conventional approach. This technique enhanced early functional recovery, reduced postoperative complications, and improved overall hip stability. Further research with larger sample sizes is recommended to validate these findings. Keywords: Total hip replacement, piriformis muscle-sparing, posterior approach, hip stability, clinical outcomes, biomechanics, functional recovery.