Optimizing total hip arthroplasty: the gripper table mounted system for enhanced soft tissue preservation and postoperative outcomes

Background: In total hip arthroplasty (THA), soft tissue retraction is crucial, but traditional methods may cause damage. This study addresses the issue by introducing the Gripper Table Mounted System, a pulley-based retraction system. The research compares THA outcomes with and without the Gripper system, whether reducing soft tissue damage and postoperative pain. The Gripper, with its unique design, aims to minimize tissue damage during surgery.

Materials and methods: The study conducted a retrospective analysis of 180 patients (180 hips) who underwent THA via an antero-lateral approach with the Gripper System or conventional retraction methods. Primary outcomes included gluteus medius cross-sectional area and hip abductor muscle strength. Secondary outcomes were pain VAS, intraoperative bleeding, operative time, laboratory data, and WOMAC score.

Results: The study compared outcomes between those using the Gripper System (Gripper + group, n = 58) and those without (Gripper - group, n = 122). Both groups exhibited no significant differences in demographics or operative parameters. Gripper + group showed enhanced recovery in gluteus medius cross-sectional area and hip abductor muscle strength, with significant analgesia at various postoperative time points. No complications were noted in either group.

Conclusions: The Gripper system proved effective in early analgesia, swift recovery of hip strength, and preserving muscle area. Its single-use, sterile, and compact design offers advantages over traditional retractor holders or human assistance, potentially reducing soft tissue damage and postoperative pain. This study concluded the Gripper system's value in reducing pain and restoring strength in THA.

Level of evidence: Therapeutic Level III.

Trial registration: The University Hospital Medical Information Network (UMIN) registration number UMIN000052948.