{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:28:11Z","timestamp":1786663691096,"version":"build-2736575974"},"reference-count":48,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The use of minimally invasive techniques for total hip arthroplasty (THA) in at-risk patients is still debated. The purpose of this prospective study was to determine the clinical and radiographic results of obese patients undergoing THA compared with those of normal-weight patients. Material and methods: A total of 476 patients of the 516 patients who underwent THA via the minimally invasive SuperPath approach between January 2016 and December 2019 attended the 1-year follow-up. Based on the WHO criteria for obesity, 22 patients were underweight, 147 were normal-weight, 186 were overweight, 73 were grade 1 obese, 25 grade 2 obese and 22 grade 3 obese. The clinical outcomes were evaluated using the Forgotten Joint Score (FJS). Radiographic analysis was performed with the digital software tool mediCad (HECTEC, Landshut, Germany).<\/jats:p>\n                  <jats:p>The mean operating time was significantly longer at 81\u00a0min (55\u201396) in grade-3 obese patients than in underweight patients with 67\u00a0min (52\u201379; p\u00a0=\u00a00.01), normal-weight patients with 71\u00a0min (34\u2013105; p\u00a0=\u00a00.04) and overweight patients with 70\u00a0min (50\u2013100; p\u00a0=\u00a00.04). There were no significant differences between the six groups with regard to the hemoglobin drop between the preoperative state and the 2nd and 4th postoperative day. The mean \u201ctime to stairs\u201d did not differ significantly (p\u00a0&gt;\u00a00.05) between the six study groups. Normal-weight patients had a significantly lower inclination with 38.6\u00b0 compared to overweight patients (40.3\u00b0; p\u00a0=\u00a00.04) and patients with grade 1 obesity (41.2\u00b0; p\u00a0=\u00a00.02). The inclination angles of patients with grade 2 (42.5\u00b0) and grade 3 obesity (42.6\u00b0) were highly significantly higher (p\u00a0&lt;\u00a00.01) than in normal-weight patients. The mean anteversion angle of underweight patients (16.2\u00b0) was significantly lower than in normal-weight patients (17.6\u00b0; p\u00a0=\u00a00.03), overweight patients (17.8\u00b0, p\u00a0=\u00a00.02) and patients with grade 2 obesity (17.4\u00b0; p\u00a0=\u00a00.04). The mean anteversion angles in patients with grade 1 (18.3\u00b0) and grade 3 (18.1\u00b0) obesity were highly significantly higher than in underweight patients. The mean FJS-12 did not differ significantly (p\u00a0&gt;\u00a00.05) between the six cohorts. Five patients had complications in the early postoperative period, three of whom were normal-weight.<\/jats:p>\n                  <jats:p>The current study shows that obese patients undergoing THA via the minimally invasive SuperPath approach have equivalent complication rates and clinical and radiographic outcomes at the 1-year follow up compared with normal-weight and overweight patients.<\/jats:p>","DOI":"10.1055\/a-2914-3785","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:00:04Z","timestamp":1786662004000},"source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Hip Arthroplasty via SuperPath Approach in Obese Patients \u2013 A Prospective Study"],"prefix":"10.1055","author":[{"given":"Henning","family":"Quitmann","sequence":"additional","affiliation":[{"name":"Gelenkzentrum Bergischland, Germany","place":["Remscheid"],"department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"University of Duisburg-Essen, Germany","place":["M\u00fclheim an der Ruhr"],"department":["Orthopaedic and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Vasiliuk","sequence":"additional","affiliation":[{"name":"University of Duisburg-Essen, University Hospital Essen, Germany","place":["Essen"],"department":["Orthopaedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6847-2205","authenticated-orcid":false,"given":"Andr\u00e9","family":"Busch","sequence":"additional","affiliation":[{"name":"Gelenkzentrum Bergischland, Germany","place":["Remscheid"],"department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: total hip replacement","volume":"370","author":"ID Learmonth","year":"2007","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/j.1445-2197.2004.02971.x","article-title":"Minimally invasive surgery for hip replacement","volume":"74","author":"SF Schofield","year":"2004","journal-title":"ANZ J Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2474-15-80","article-title":"The minimal invasive direct anterior approach in combination with large heads in total hip arthroplasty\u2014is dislocation still a major issue? 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A Cohort Study of 98 Patients 1 Year after Surgery","volume":"85","author":"A Liljens\u00f8e","year":"2019","journal-title":"Acta Orthop Belg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"208","DOI":"10.3390\/jfmk9040208","article-title":"Functional Recovery After Hip Arthroplasty with a Minimal Invasive or Classical Approach Eight Years After Intervention","volume":"9","author":"M Vuckovic","year":"2024","journal-title":"J Funct Morphol Kinesiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"217","DOI":"10.2106\/00004623-197860020-00014","article-title":"Dislocations after total hip-replacement arthroplasties","volume":"60","author":"GE Lewinnek","year":"1978","journal-title":"J Bone Joint Surg Am"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.arth.2018.10.034","article-title":"Functional safe zone is superior to the Lewinnek safe zone for total hip arthroplasty: why the Lewinnek safe zone is not always predictive of stability","volume":"34","author":"T Tezuka","year":"2019","journal-title":"J Arthroplasty"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1002\/jbm.b.33991","article-title":"An in vitro simulation model to assess the severity of edge loading and wear, due to variations in component positioning in hip joint replacements","volume":"106","author":"O O\u2019Dwyer Lancaster-Jones","year":"2018","journal-title":"J Biomed Mater Res B Appl Biomater"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"vi","DOI":"10.1016\/S1047-9651(03)00130-X","article-title":"Shoulder pain in hemiplegia","volume":"15","author":"D Yu","year":"2004","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1302\/0301-620X.92B11.24702","article-title":"Transient subluxation of the femoral head after total hip replacement","volume":"92","author":"BJ McGrory","year":"2010","journal-title":"J Bone Joint Surg Br"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1007\/s00264-003-0474-5","article-title":"Osseointegration in hip prostheses: experimental study in sheep","volume":"27","author":"C Doria","year":"2003","journal-title":"Int Orthop"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"467","DOI":"10.3390\/jcm13020467","article-title":"Does Body Mass Index (BMI) Affect the Reconstruction of Biomechanical Parameters in Patients Undergoing Total Hip Replacement (THR) through the Direct Anterior Approach (DAA)?","volume":"13","author":"M Wei\u00dfenberger","year":"2024","journal-title":"J Clin Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1007\/s11999-012-2561-7","article-title":"Risk factors for dislocation after revision total hip arthroplasty","volume":"471","author":"NG Wetters","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"347","DOI":"10.3238\/arztebl.2017.0347","article-title":"Periprosthetic Infection in Joint Replacement","volume":"114","author":"C Otto-Lambertz","year":"2017","journal-title":"Dtsch Arztebl Int"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1710","DOI":"10.1007\/s11999-008-0209-4","article-title":"Periprosthetic joint infection: the incidence, timing, and predisposing factors","volume":"466","author":"L Pulido","year":"2008","journal-title":"Clin Orthop Relat Res"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1302\/0301-620X.98B4.37201","article-title":"Epidemiology of periprosthetic fracture of the femur in 32,644 primary total hip arthroplasties: a 40-year experience","volume":"98-B","author":"MP Abdel","year":"2016","journal-title":"Bone Joint J"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2494679","article-title":"Risk factors for periprosthetic femoral fractures following hip arthroplasty: a systematic review and meta-analysis","volume":"57","author":"WQ Zhao","year":"2025","journal-title":"Ann Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1051\/sicotj\/2025021","article-title":"Safety and outcomes of bikini-incision DAA for hip arthroplasty with large acetabular cups (\u2265\u00a056\u00a0mm): A single-surgeon series of 215 cases","volume":"11","author":"F Mat Salleh","year":"2025","journal-title":"SICOT J"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"417","DOI":"10.3109\/17453674.2011.588859","article-title":"Obesity in total hip arthroplasty--does it really matter? 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