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Direct anterior hip arthroplasty

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https://www.readbyqxmd.com/read/28089468/obtain-a-outcome-benefits-of-tranexamic-acid-in-hip-arthroplasty-a%C3%A2-randomized-double-blinded-controlled-trial
#1
Andrew Fraval, Peter Effeney, Lena Fiddelaers, Belinda Smith, Ben Towell, Phong Tran
BACKGROUND: We examined whether the blood conserving effect of tranexamic acid (TXA) in total hip arthroplasty using the direct anterior approach, translates to an effect on functional outcomes in the perioperative period. METHODS: We conducted a single-center, randomized, double-blinded, placebo-controlled trial. One hundred one patients were randomized to receive either TXA or an equivalent volume of normal saline. The primary outcome measure was thigh swelling...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087159/the-direct-anterior-approach-for-complex-primary-total-hip-arthroplasty-the-extensile-acetabular-approach-on-a-regular-operating-room-table
#2
Ben Molenaers, Ronald Driesen, Guy Molenaers, Kristoff Corten
BACKGROUND: The direct anterior approach on a regular operating room table has been reported with low dislocation rates. This might be beneficial for complex primary total hip arthroplasty (THA) such as in patients with cerebral palsy or following femoral or pelvic osteotomies. Extending the approach is often required to overcome problems such as acetabular deformities or severe contractures. METHODS: We retrospectively evaluated the results and complications of 29 patients with 37 complex primary THA in which an extensile approach was used...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28024885/heterotopic-ossification-in-primary-total-hip-arthroplasty-using-the-direct-anterior-vs-direct-lateral-approach
#3
Pouya Alijanipour, Ripal P Patel, Tejal U Naik, Javad Parvizi
BACKGROUND: The formation and severity of heterotopic ossification (HO) may be influenced by type of surgical approach. Our hypothesis was that because of differences in soft tissue dissection, differences exist in HO formation in primary total hip arthroplasty using direct anterior (DA) vs direct lateral (DL) approach. METHODS: A total of 1482 consecutive patients with DL (736) or DA (746) approach and similar perioperative care protocol during 2009-2011 were retrospectively studied...
November 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28002219/do-transcortical-screws-in-a-locking-plate-construct-improve-the-stiffness-in-the-fixation-of-vancouver-b1-periprosthetic-femur-fractures-a-biomechanical-analysis-of-2-different-plating-constructs
#4
Jasjit Lochab, Andrew Carrothers, Edwin Wong, Stewart McLachlin, Wassim Aldebeyan, Richard Jenkinson, Cari Whyne, Markku T Nousiainen
OBJECTIVES: This biomechanical study compared Vancouver B1 periprosthetic femur fractures fixed with either a locking plate and anterior allograft strut construct or an equivalent locking plate with locking attachment plates construct in paired cadaveric specimens. METHODS: After 9 pairs of cadaveric femora were implanted with a cemented primary total hip arthroplasty, an oblique osteotomy was created distal to the cement mantle. Femora underwent fixation with either: (1) a locking plate with anterior strut allograft (locking compression plating (LCP)-Allograft) or (2) a locking plate with 2 locking attachment plates (LAPs) (LCP-LAP)...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27973946/effect-of-soft-tissue-impingement-on-range-of-motion-during-posterior-approach-total-hip-arthroplasty-an-in-vivo-measurement-study
#5
Nobuo Nakamura, Yuki Maeda, Makoto Hamawaki, Takashi Sakai, Nobuhiko Sugano
PURPOSE: While implant impingement and bony impingement have been recognized as causes of poor outcomes in total hip arthroplasty (THA), reports of soft-tissue impingement are rare. To clarify the issue, the effect of anterior capsule resection on hip range of motion (ROM) was quantitatively measured in vivo during posterior approach THA using a CT-based hip navigation system. MATERIALS AND METHODS: For 47 patients (51 hips), hip ROM was measured intraoperatively before and after resection of the anterior hip capsule, and the difference was compared...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27922457/daily-physical-activity-in-total-hip-arthroplasty-patients-undergoing-different-surgical-approaches-a-cohort-study
#6
Monika Engdal, Olav A Foss, Kristin Taraldsen, Vigdis S Husby, Siri B Winther
OBJECTIVE: Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. DESIGN: A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach...
December 2, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#7
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/27876253/the-impact-of-surgical-technique-on-patient-reported-outcome-measures-and-early-complications-after-total-hip-arthroplasty
#8
Udai S Sibia, Timothy R Turner, James H MacDonald, Paul J King
BACKGROUND: This study examines patient and surgeon reported outcome measures, complications during index admission, length of stay (LOS), and discharge disposition in a series of total hip replacements (THR) performed via the direct anterior (DA) or posterolateral (PL) approach. METHODS: Five surgeons performed 2698 total hip replacements (1457 DA vs 1241 PL) between January 2010 and June 2015. Complications during index admission were recorded using billing and claims data...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27853816/total-hip-arthroplasty-using-direct-anterior-approach-and-dual-mobility-cup-safe-and-efficient-strategy-against-post-operative-dislocation
#9
Cécile Batailler, Camdon Fary, Pierre Batailler, Elvire Servien, Philippe Neyret, Sébastien Lustig
AIM: We hypothesize that a dual mobility cup can be safely used via the direct anterior approach, without increasing the risk of complications or incorrect positioning. MATERIALS AND METHODS: This retrospective study compared 201 primary total hip arthroplasties using a dual mobility cup performed via direct anterior approach without a traction table, to 101 arthroplasties performed via posterolateral approach. Implant positioning, function scores, and early complications were recorded...
November 16, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27846875/the-design-of-a-randomised-controlled-trial-to-evaluate-the-cost-effectiveness-of-the-posterolateral-versus-the-direct-anterior-approach-for-tha-polada-trial
#10
K Rykov, I H F Reininga, B A S Knobben, M S Sietsma, B L E F Ten Have
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopaedic procedures. Because of the increasing number of THAs, a growing demand for faster recovery and a greater emphasis on cost-effectiveness, minimally invasive THAs have been introduced in the last decades. The direct anterior approach is a minimally invasive, tissue-sparing approach in which intermuscular planes are used. Theoretically, this approach should result in a faster recovery of physical functioning and higher health-related quality of life...
November 15, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27843039/the-direct-anterior-approach-is-associated-with-early-revision-total-hip-arthroplasty
#11
Shuichi Eto, Katherine Hwang, James I Huddleston, Derek F Amanatullah, William J Maloney, Stuart B Goodman
BACKGROUND: The direct anterior approach for total hip arthroplasty (THA) has generated increased interest recently. The purpose of this study was to compare the duration to failure and reasons for revision of primary THA performed elsewhere and subsequently revised at our institution after the direct anterior vs other nonanterior surgical approaches to the hip. METHODS: All primary THAs performed elsewhere and referred to our institution for revision were divided into the direct anterior approach (30 cases) or nonanterior approach groups (100 cases, randomly selected from 453 cases) based on the original surgical approach...
October 8, 2016: Journal of Arthroplasty
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/27737297/direct-anterior-versus-posterior-simultaneous-bilateral-total-hip-arthroplasties-no-major-differences-at-90-days
#18
Chad D Watts, Matthew T Houdek, Cody C Wyles, Rafael J Sierra, Robert T Trousdale, Michael J Taunton
We conducted a study to compare 90-day outcomes of patients who underwent simultaneous bilateral total hip arthroplasties (THAs) through the direct anterior (DA) approach (n = 19 patients) or the posterior approach (n = 21) over a 2-year period (2012-2014). Compared with patients in the posterior group, patients in the DA group had longer operative times (153 vs 106 min; P < .001) and longer anesthesia times (257 vs 221 min; P = .007) but were more likely to be discharged home (100.0% vs 71.4%; P = .02)...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27703417/higher-acetabular-anteversion-in-direct-anterior-total-hip-arthroplasty-a-retrospective-case-control-study
#19
Antonia F Chen, Chi-Lung Chen, Sara Low, Wei-Ming Lin, Karthikeyan Chinnakkannu, Fabio R Orozco, Alvin C Ong, Zachary D Post
BACKGROUND: Surgical approach is known as a risk factor that influences cup malposition while performing total hip arthroplasty (THA). However, no study has been conducted comparing cup positioning between the supine direct anterior (DA) and supine direct lateral (DL) THA approaches. QUESTIONS/PURPOSES: (1) Is there a difference in acetabular cup positioning between supine DA and supine DL THA approaches? (2) Are there differences in complications based on acetabular cup positioning between the two approaches? METHODS: From 2012 to 2014, 186 patients who underwent primary THAs using DA approach were matched with 186 patients using DL approach by body mass index, age, and gender...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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
#20
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
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