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DAA total hip arthroplasty

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https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#1
Matthew L Brown, Johannes F Plate, David C Holst, Daniel N Bracey, Matthew W Bullock, Jason E Lang
INTRODUCTION: 15%-20% of patients presenting for total hip arthroplasty (THA) have bilateral disease. While simultaneous bilateral THA is of interest to patients and surgeons, debate persists regarding its merits. The majority of previous reports on simultaneous bilateral THA involve patients in the lateral decubitus position, which require repositioning, prepping and draping, and exposure of a fresh wound to pressure and manipulation for the contralateral THA. The purpose of this study was to compare complications, component position, and financial parameters for simultaneous versus staged bilateral THAs using the direct anterior approach (DAA)...
November 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27842584/risk-of-infection-in-primary-elective-total-hip-arthroplasty-with-direct-anterior-approach-or-lateral-transgluteal-approach-a-prospective-cohort-study-of-1104-hips
#2
Thomas Ilchmann, Werner Zimmerli, Lilianna Bolliger, Peter Graber, Martin Clauss
BACKGROUND: The direct anterior approach (DAA) is increasingly popular for hip replacement. However, the small incision and the location near to the groin might increase the risk of periprosthetic joint infection (PJI). We asked the questions (i) whether there is an increased risk of infection for this approach, and (ii) whether the spectrum of microorganisms differs between patients with DAA and those with lateral transgluteal approach (LAT). METHODS: All patients operated between 08/2006 and 12/2013 were followed prospectively in an in house register...
November 14, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27837328/in-total-hip-arthroplasty-via-the-direct-anterior-approach-a-dual-mobility-cup-prevents-dislocation-as-effectively-in-hip-fracture-as-in-osteoarthritis
#3
Yasuhiro Homma, Tomonori Baba, Yu Ozaki, Taiji Watari, Hideo Kobayashi, Hironori Ochi, Mikio Matsumoto, Kazuo Kaneko
PURPOSE: The main purpose of this study was to compare the outcome of total hip arthroplasty (THA) via the direct anterior approach (DAA) using a dual-mobility cup (DMC) in patients with femoral neck fracture to those in patients undergoing elective THA for osteoarthritis. PATIENTS AND METHODS: We retrospectively investigated 40 hips with femoral neck fracture (group A), and 81 hips with osteoarthritis (group B). THA via the DAA using the DMC was performed in both groups...
November 11, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27831458/direct-anterior-approach-versus-posterolateral-approach-in-total-hip-arthroplasty%C3%A2-one-surgeon-two-approaches
#4
B Fransen, M Hoozemans, S Vos
Early research shows several advantages of the Direct Anterior Approach (DAA) in total hip arthroplasty (THA), although no studies evaluated the DAA on a regular operating table without using fluoroscopy. We performed a retrospective cohort study on the outcome of this variation of the DAA compared with the posterolateral approach (PLA) with one year follow-up. All procedures were uncemented THA performed in 2012 by a single surgeon. Patients in the DAA group (N = 45) had a lower Body Mass Index (p > ...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27822002/limited-benefits-of-the-direct-anterior-approach-in-primary-hip-arthroplasty-a-prospective-single-centre-cohort-study
#5
Jetse Jelsma, Rik Pijnenburg, Harm W Boons, Peter J M G Eggen, Lucas L A Kleijn, Herman Lacroix, Hub J Noten
BACKGROUND: Since years a discussion is held on the best approach to perform total hip replacement (THR). Risk of dislocation, abductor weakness and a possible difference in rehabilitation are mentioned. We performed this study to objectify that the use of the direct anterior approach (DAA) results in a faster rehabilitation after THR compared to the non-DAA (posterolateral and anterolateral) approach. METHODS: A single centre prospective cohort study was conducted...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27817996/patient-perceptions-of-the-direct-anterior-hip-arthroplasty
#6
William H Trousdale, Michael J Taunton, Tad M Mabry, Matthew P Abdel, Robert T Trousdale
BACKGROUND: The quest for less invasive surgical approaches for total hip arthroplasty (THA) has garnered much attention recently in the community, as well as media outlets. There are very little data demonstrating the actual differences in these approaches. We are unaware of any information documenting patients' perceptions of the direct anterior approach (DAA) for THA. The purpose of this study was to collect information regarding patients' perceptions of the DAA THA. METHODS: We surveyed 166 consecutive new patients being evaluated for hip osteoarthritis in our outpatient clinic...
October 13, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27777087/small-femoral-offset-is-a-risk-factor-for-lateral-femoral-cutaneous-nerve-injury-during-total-hip-arthroplasty-using-a-direct-anterior-approach
#7
Y Ozaki, Y Homma, K Sano, T Baba, H Ochi, A Desroches, M Matsumoto, T Yuasa, K Kaneko
INTRODUCTION: Lateral femoral cutaneous nerve (LFCN) injury is a risk specific to the direct anterior approach (DAA) for total hip arthroplasty (THA). However, prevention strategies have not been established. This study aimed to identify the predisposing factors determining LFCN injury during THA via a DAA. HYPOTHESIS: Patients with LFCN injury after THA via DAA would demonstrate predisposing factors. MATERIAL AND METHODS: LFCN injury was identified using a patient questionnaire...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27687805/a-prospective-randomized-clinical-trial-in-total-hip-arthroplasty-comparing-early-results-between-the-direct-anterior-approach-and-the-posterior-approach
#8
Tze E Cheng, Jason A Wallis, Nicholas F Taylor, Chris T Holden, Paul Marks, Catherine L Smith, Michael S Armstrong, Parminder J Singh
BACKGROUND: We report a prospective randomized study comparing early clinical results between the direct anterior approach (DAA) and posterior approach (PA) in primary hip arthroplasty. METHODS: Surgeries were performed by 2 senior hip arthroplasty surgeons. Seventy-two patients with complete data were assessed preoperatively 2, 6, and 12 weeks postoperatively. The primary outcomes were the Western Ontario McMasters Arthritis Index and Oxford Hip Scores. Secondary outcome measures included the EuroQoL, 10-meter walk test, and clinical and radiographic parameters...
August 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27686547/-direct-anterior-approach-versus-posterolateral-approach-for-total-hip-arthroplasty-in-the-lateral-decubitus-position
#9
Z L Luo, M Chen, X F Shang, F Hu, Z Ni, P Cheng, X F Ji, K R Wu, X Q Zhang
Objective: To compare the clinical efficacy of the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in the lateral decubitus position. Methods: From July to December, 2014, 104 patients randomly divided into two equal groups of the DAA group and the PLA group underwent unilateral primary THA procedures.All procedures were performed by the same surgeon in the Department of Orthopaedics, the Affiliated Anhui Provincial Hospital of Anhui Medical University.General data, perioperative index, postoperative function and radiological evaluation were recorded and statistically analyzed...
September 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27658640/24%C3%A2-hours-stay-after-hip-replacement
#10
Yannick N T Van Den Eeden, Bruno J G De Turck, Frank M C Van Den Eeden
Background and purpose - The length of stay after total hip arthroplasty has been reduced to 2-4 days after implementing fast-track surgery. We investigated whether a new time-based patient-centered primary direct anterior approach (DAA) total hip arthroplasty (THA) treatment protocol in a specialized clinic, with a planned length of stay of about 24 hours, could be achieved in all patients or only in a selected group of patients. Patients and methods - We analyzed prospectively collected data in a cohort of 378 consecutive patients who underwent a primary direct anterior THA as a patient-centered time-based procedure between March 1, 2012 and December 31, 2015...
September 23, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27612607/a-comparison-of-radiographic-outcomes-after-total-hip-arthroplasty-between-the-posterior-approach-and-direct-anterior-approach-with-intraoperative-fluoroscopy
#11
Timothy J Lin, Ilya Bendich, Alex S Ha, Benjamin J Keeney, Wayne E Moschetti, Ivan M Tomek
BACKGROUND: Radiographic outcomes after total hip arthroplasty (THA) have been linked to clinical outcomes. The direct anterior approach (DAA) for THA has been criticized by some for providing limited exposure and compromised implant position but allows for routine use of intraoperative fluoroscopy. We sought to determine whether radiographic measurements differed by THA approach using prospective cohorts. METHODS: Two reviewers blinded to surgical approach examined 194 radiographs, obtained 4-6 weeks after primary THA, and obtained measurements for acetabular inclination angle, acetabular anteversion, radiographic limb length discrepancy (LLD), and femoral offset...
August 10, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27515242/distal-extension-of-the-direct-anterior-approach-to-the-hip-a-cadaveric-feasibility-study
#12
Stijn G M Ghijselings, Ronald Driesen, Jean-Pierre Simon, Kristoff Corten
BACKGROUND: The direct anterior approach (DAA) is becoming more popular as the standard surgical approach for primary total hip arthroplasty. However, femoral complications of up to 2.8% have been reported. Therefore, it is important for surgeons to understand the periarticular neurovascular anatomy in order to safely deal with intraoperative complications. METHODS: Anatomic dissections were performed on 20 cadaveric hips. The neurovascular structures anterior to the femur and distal to the intertrochanteric line were dissected and its position was described in relation to anatomic landmarks easily identified through the DAA: anterior superior iliac spine (ASIS), the insertion of the gluteus minimus (GM), and the lesser trochanter (LT)...
July 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27369300/direct-anterior-approach-for-total-hip-arthroplasty-in-the-lateral-decubitus-position-our-experiences-and-early-results
#13
Min Chen, Zhengliang Luo, Xiaofeng Ji, Peng Cheng, Guolin Tang, Xifu Shang
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty (THA) is typically performed in the supine position using a specially designed operating room table, which makes this approach more accessible to orthopedic surgeons. We attempted to perform this procedure in the lateral decubitus position on an ordinary operation table to avoid dependence on a special operating room table. There is an obvious absence of literature regarding this subject. METHODS: A total of 248 patients (295 hips) were recruited for primary THAs from July 1, 2014 to December 31, 2014...
June 7, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27324194/greater-trochanter-chip-fractures-in-the-direct-anterior-approach-for-total-hip-arthroplasty
#14
Yasuhiro Homma, Tomonori Baba, Hironori Ochi, Yu Ozaki, Hideo Kobayashi, Mikio Matsumoto, Takahito Yuasa, Kazuo Kaneko
BACKGROUND: The direct anterior approach (DAA) for the treatment of total hip arthroplasty (THA) has gained popularity in recent years. Chip fractures of the greater trochanter are frequently seen, but the risk factors for such fractures are unknown. The study aimed to identify the risk factors for chip fractures in patients undergoing primary THA by the DAA during the surgeons' learning curve. MATERIALS AND METHODS: From November 2011 to April 2015, the first experiences of three surgeons who performed 120 THAs by the DAA (120 hips; 40 cases per beginner surgeon) were included...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27311447/benefit-and-risk-in-short-term-after-total-hip-arthroplasty-by-direct-anterior-approach-combined-with-dual-mobility-cup
#15
Yasuhiro Homma, Tomonori Baba, Hideo Kobayashi, Asuka Desroches, Hironori Ochi, Yu Ozaki, Mikio Matsumoto, Takahito Yuasa, Kazuo Kaneko
PURPOSE: No previous reports have described the benefits and risks associated with the dual mobility cup (DMC) in primary THA via direct anterior approach (DAA). The aim of this study was to compare the safety and rate of early postoperative complication of the DAA with the DMC for THA with those of the DAA with a single standard cup, and to investigate the influence of the learning curve of the use of DMC on intra- and perioperative outcomes. METHODS: We retrospectively investigated 60 hips treated in the single-DAA group and 60 hips treated in the dual-DAA group...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27267230/risk-factors-for-wound-complications-after-direct-anterior-approach-hip-arthroplasty
#16
Kenneth H Jahng, Marcel A Bas, Jose A Rodriguez, H John Cooper
BACKGROUND: Previous studies have suggested that wound complications may be higher after direct anterior approach (DAA) hip arthroplasty, but, specific risk factors have not been closely examined. METHODS: We conducted a retrospective case-control study of 651 consecutive DAA hip arthroplasty surgeries performed by 2 surgeons over a 3-year period. Outcome measures included any postoperative wound problem (including prolonged drainage, wound dehiscence, wound necrosis, suture granuloma, and superficial infection) requiring additional intervention or reoperation...
May 6, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27235516/a-comparison-between-the-direct-anterior-and-posterior-approaches-for-total-hip-arthroplasty-the-role-of-an-enhanced-recovery-pathway
#17
I A Malek, G Royce, S U Bhatti, J P Whittaker, S P Phillips, I R B Wilson, J R Wootton, I Starks
AIMS: We assessed the difference in hospital based and early clinical outcomes between the direct anterior approach and the posterior approach in patients who undergo total hip arthroplasty (THA). PATIENTS AND METHODS: The outcome was assessed in 448 (203 males, 245 females) consecutive patients undergoing unilateral primary THA after the implementation of an 'Enhanced Recovery' pathway. In all, 265 patients (mean age: 71 years (49 to 89); 117 males and 148 females) had surgery using the direct anterior approach (DAA) and 183 patients (mean age: 70 years (26 to 100); 86 males and 97 females) using a posterior approach...
June 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27133929/severely-obese-patients-have-a-higher-risk-of-infection-after-direct-anterior-approach-total-hip-arthroplasty
#18
Richard L Purcell, Nancy L Parks, Jeanine M Gargiulo, William G Hamilton
BACKGROUND: The orthopedic literature documents that obesity can place patients at increased risk for complications. This is the first study to document the increased risk of infection in obese patients after direct anterior approach (DAA) primary total hip arthroplasty (THA). METHODS: We retrospectively evaluated 1621 consecutive primary THAs performed with a DAA. Patients were stratified by body mass index <35 kg/m(2) (group 1) or ≥35 kg/m(2) (group 2). Rates of postoperative infection requiring revision, superficial wound dehiscence, return to the operating room, and total wound complications were compared...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27067754/no-difference-in-dislocation-seen-in-anterior-vs-posterior-approach-total-hip-arthroplasty
#19
Joseph D Maratt, Joel J Gagnier, Paul D Butler, Brian R Hallstrom, Andrew G Urquhart, Karl C Roberts
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty (THA) has rapidly become popular, but there is little consensus regarding the risks and benefits of this approach in comparison with a modern posterior approach (PA). METHODS: A total of 2147 patients who underwent DAA THA were propensity score matched with patients undergoing PA THA on the basis of age, gender, body mass index, and American Society of Anesthesia classification using data from a state joint replacement registry...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27067169/acetabular-abduction-and-dislocations-in-direct-anterior-vs-posterior-total-hip-arthroplasty-a-retrospective-matched-cohort-study
#20
Krishna R Tripuraneni, Natalie R Munson, Michael J Archibeck, Joshua T Carothers
BACKGROUND: There is purported improvement in component positioning and hip stability with the use of direct anterior approach (DAA) total hip arthroplasty (THA). We sought to determine if there is a difference in acetabular component position or dislocation frequency between DAA and posterior THA. METHODS: One arthroplasty fellowship-trained surgeon introduced DAA THA into his practice. From the initiation of DAA in 4/2012-8/2015, this comparative series resulted in 66 DAA THAs...
October 2016: Journal of Arthroplasty
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