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Direct anterior hip arthroplasty

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https://www.readbyqxmd.com/read/29206792/direct-anterior-hip-replacement-does-not-pose-undue-radiation-exposure-risk-to-the-patient-or-surgeon
#1
David Clinton McNabb, Jason M Jennings, Daniel L Levy, Todd M Miner, Charlie C Yang, Raymond H Kim
BACKGROUND: The fluoroscopically assisted direct anterior approach for total hip arthroplasty has gained interest in recent years. One of the perceived advantages is the use of fluoroscopy to aid in the positioning of implants. The purpose of this study was to measure the radiation entrance surface dose to anatomically important areas of both patients and surgeons during direct anterior approach total hip arthroplasty. METHODS: Radiation dosimetry badges were placed at the sternal notch and pubic symphysis of 50 patients undergoing direct anterior approach total hip arthroplasty...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29204490/lumbar-chance-fracture-after-direct-anterior-total-hip-arthroplasty
#2
Michael Pitta, Corey J Wallach, Colleen Bauk, William G Hamilton
This report describes a patient with ankylosing spondylitis (AS) who underwent total hip arthroplasty (THA) by the direct anterior approach and sustained a L4-5 extension fracture dislocation with neural deficits. A magnetic resonance imaging revealed an epidural hematoma at the site of the fracture causing critical stenosis. The patient was taken to the operating room for a L3-S1 posterior decompression with L2-pelvis posterior spinal fusion. AS and diffuse idiopathic skeletal hyperostosis create a stiff spine that predisposes to fractures because of the larger moment arms experienced than normal spines...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29200484/treatment-of-femoroacetabular-impingement-with-a-mini-open-direct-anterior-approach
#3
Paweł Skowronek, Marek Synder, Michał Polguj, Dariusz Marczak, Marcin Sibiński
Background: The opinion about best methods of femoroacetabular impingement (FAI) treatment are not consistent. Operative treatment of this condition may be arthroscopic, but open procedures with osteotomy of the greater trochanter and hip dislocation has been used. The present study evaluates the benefits of the mini-open direct anterior approach (DAA) in treating patients with FAI, with is a procedure available for most orthopedic surgeons. Materials and Methods: 39 patients treated for FAI (25 men and 14 women) at an average age of 29...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29195847/trochanteric-bursitis-following-primary-total-hip-arthroplasty-incidence-predictors-and-treatment
#4
Shai S Shemesh, Calin S Moucha, Aakash Keswani, Nolan A Maher, Darwin Chen, Michael J Bronson
BACKGROUND: Trochanteric bursitis (TB) remains a common complication after total hip arthroplasty (THA), with an incidence between 3% and 17%, depending on the surgical approach, with the posterior approach (PA) being relatively protective compared to the lateral approach. The purposes of this study were to determine the incidence of TB after primary THA, identify potential risk factors for TB, and examine the utility of different modes of treatment. METHODS: Retrospective cohort data of 990 primary THAs performed in a single institution, including 613 PAs and 377 direct anterior approaches (DAAs), were analyzed...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29186943/modified-minimally-invasive-direct-anterior-approach-through-a-bikini-incision-for-total-hip-arthroplasty-technique-and-results-in-young-female-patients
#5
C Faldini, A Mazzotti, F Perna, N Stefanini, A Panciera, F Pilla, A Ruffilli, E M Neonakis, F Traina
Direct anterior approach for THA has gained popularity over the last years. However, concerns have been raised regarding the cosmetic, related to the incision that does not respect the Langer’s skin tension line and may produce hypertrophic scars. The aim of this study was to analyze the preliminary results in 22 young female patients undergoing THA through a minimally invasive direct anterior approach using a modified oblique bikini incision. Clinical evaluations showed an improvement of WOMAC, UCLA and Harris Hip Score at 5-month follow-up...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29185307/direct-anterior-approach-versus-posterolateral-approach-in-total-hip-arthroplasty-effects-on-early-post-operative-rehabilitation-period
#6
C Faldini, F Perna, A Mazzotti, N Stefanini, A Panciera, G Geraci, P Mora, F Traina
Main surgical approaches to the hip have been modified during last decades, in an effort to reduce invasiveness of the surgical procedure and allow a faster rehabilitation. Direct anterior approach is the only approach, which does not require muscle detachment, thus theoretically leading to reduced post-operative pain and allows earlier recovery. The aim of this study was to report a comparison between patients operated with direct anterior approach and postero-lateral approach in terms of immediate post-operative and in-hospital records...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29177540/the-distance-of-the-gluteal-nerve-in-relation-to-anatomical-landmarks-an-anatomic-study
#7
David Putzer, Matthias Haselbacher, Romed Hörmann, Martin Thaler, Michael Nogler
INTRODUCTION: Gluteal insufficiency is of concern with lateral approaches to total hip arthroplasty. Damage to the branches of the superior gluteal nerve may cause degeneration of the innervated muscles. The direct anterior approach exploits the intermuscular and internerval interval between tensor fasciae latae laterally and sartorius and rectus femoris muscle medially. In this study, the distance of the superior gluteal nerve in relation to anatomical landmarks was determined. MATERIALS AND METHODS: Two experienced surgeons implanted trial components in 15 alcohol glycerol fixed cadavers with 30 hips...
November 25, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#8
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107490/cementless-tapered-wedge-stem-length-affects-the-risk-of-periprosthetic-femoral-fractures-in-direct-anterior-total-hip-arthroplasty
#9
Tatsuya Tamaki, Kurato Jonishi, Yoko Miura, Kazuhiro Oinuma, Hideaki Shiratsuchi
BACKGROUND: Although the popularity of the direct anterior approach for total hip arthroplasty has increased, the femoral procedure in this approach is considered technically challenging, and one of the most frequent complications reported was periprosthetic femoral fractures. The present study aimed to identify factors for predicting the risk of periprosthetic femoral fractures after using stems with a cementless tapered-wedge design through the direct anterior approach. METHODS: We retrospectively assessed the medical records of 686 patients (851 hips) who underwent primary total hip arthroplasty using a single stem with a cementless tapered-wedge design having a short or standard length option...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29066111/internet-promotion-of-direct-anterior-approach-total-hip-arthroplasty-by-members-of-the-american-association-of-hip-and-knee-surgeons
#10
Ademola I Shofoluwe, Neal B Naveen, Avinash Inabathula, Mary Ziemba-Davis, R Michael Meneghini, John J Callaghan, Lucian C Warth
BACKGROUND: The direct anterior approach (DAA) in total hip arthroplasty is of significant interest to both patients and surgeons, largely due to intense marketing. This study addressed the question, "What is the level of promotion of DAA total hip arthroplasty on the internet by American Association of Hip and Knee Surgeons (AAHKS) members?" METHODS: An internet search was performed to identify surgeon-specific websites for each member of the AAHKS using the members' full name and a previously published set of criteria...
August 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29048696/the-direct-anterior-minimal-invasive-approach-in-total-hip-replacement-a-prospective-departmental-study-on-the-learning-curve
#11
Ole-Christian L Brun, Lukas Månsson, Lars Nordsletten
INTRODUCTION: Introduction of new surgical techniques is normal, but seldom monitored in real time. The purpose of this study was to monitor the learning curve when introducing a new surgical technique to a department. We did a prospective evaluation of the learning curve when introducing the minimally invasive direct anterior approach in total hip arthroplasty. We wish to investigate whether there is a learning curve for the direct anterior minimal invasive approach in total hip replacement and what are the early complications to this approach...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29034792/medical-resource-utilization-and-costs-for-total-hip-arthroplasty-benchmarking-an-anterior-approach-technique-in-the-medicare-population
#12
Atul F Kamath, Abhishek S Chitnis, Chantal Holy, Jason Lerner, Brian Curtin, Steve Lochow, Charles DeCook, Joel M Matta
AIMS: The anterior approach (AA) for total hip arthroplasty (THA) is associated with more rapid recovery when compared to traditional approaches. The purpose of this study was to benchmark healthcare resource utilization and costs for patients with THA via AA relative to matched patients. MATERIALS AND METHODS: This study queried Medicare claims data (2012-2014) to identify patients who received THA via an AA from experienced surgeons, and matched these patients to a control cohort (all THA approaches)...
November 3, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29032422/the-deep-layer-of-the-tractus-iliotibialis-and-its-relevance-when-using-the-direct-anterior-approach-in-total-hip-arthroplasty-a-cadaver-study
#13
David Putzer, Matthias Haselbacher, Romed Hörmann, Günter Klima, Michael Nogler
INTRODUCTION: Surgical approaches through smaller incisions reveal less of the underlying anatomy, and therefore, detailed knowledge of the local anatomy and its variations is important in minimally invasive surgery. The aim of this study was to determine the location, extension, and histomorphology of the deep layer of the iliotibial band during minimally invasive hip surgery using the direct anterior approach (DAA). MATERIALS AND METHODS: The morphology of the iliotibial tract was determined in this cadaver study on 40 hips with reference to the anterior superior iliac spine and the tibia...
October 14, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28993084/perioperative-fractures-in-cementless-total-hip-arthroplasty-using-the-direct-anterior-minimally-invasive-approach-reduced-risk-with-short-stems
#14
Michael Dietrich, Method Kabelitz, Claudio Dora, Patrick O Zingg
BACKGROUND: The direct minimally invasive anterior approach (DMIAA) and the use of uncemented stems demonstrated an increase in intraoperative fractures in recent literature. Whether the different design of the stems additionally influences the incidence of perioperative local complications, was the goal of this study. METHODS: From January 2008 until June 2010, all patients undergoing primary cementless total hip arthroplasty, using a DMIAA, were consecutively included...
September 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28984572/total-hip-arthroplasty-via-the-direct-anterior-approach-with-a-dual-mobility-cup-for-displaced-femoral-neck-fracture-in-patients-with-a-high-risk-of-dislocation
#15
Hironori Ochi, Tomonori Baba, Yasuhiro Homma, Mikio Matsumoto, Taiji Watari, Yu Ozaki, Hideo Kobayashi, Kazuo Kaneko
INTRODUCTION: Although total hip arthroplasty (THA) is superior to bipolar hemiarthroplasty (BHA) for displaced femoral neck fracture in terms of hip pain, function and reoperation rate, THA has a higher rate of dislocation. The direct anterior approach (DAA) and a dual mobility cup (DMC) are associated with lower rates of dislocation. The aim of this study was to investigate the outcomes of THA compared with BHA, and in those patients who had a THA we investigated those with a DMC (DMC-THA) and compared them with those had a single conventional cup (Single cup-THA)...
2017: SICOT-J
https://www.readbyqxmd.com/read/28956180/comparison-of-direct-anterior-lateral-posterior-and-posterior-2-approaches-in-total-hip-arthroplasty-network-meta-analysis
#16
Chinundorn Putananon, Harit Tuchinda, Alisara Arirachakaran, Siwadol Wongsak, Thana Narinsorasak, Jatupon Kongtharvonskul
Total hip arthroplasty (THA) is generally considered to be one of the most successful orthopedic surgical procedures. THA patients continue to experience symptoms, most commonly pain, which prevent their return to full function and activity. Possible causes include failure of fixation, instability and damage to soft tissues, associated with the trauma of the surgical procedure. Choosing the optimal surgical approach can minimize these risks and therefore improve the outcome of THA. Surgical approaches in THA include anterior, lateral [anterolateral (Hardinge) and direct lateral (Watson-Jones)], posterior (posterolateral and posterior) and posterior-2 techniques...
September 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28944121/direct-anterior-approach-using-navigation-improves-accuracy-of-cup-position-compared-to-conventional-posterior-approach
#17
Jason Chow, Simon Pearce, Kuk-Ki Cho, William Walter
The accuracy of cup position in total hip arthroplasty is essential for a satisfactory result as malpositioning increases the risk of complications including dislocation, high wear rate, loosening, squeaking, edge loading, impingement and ultimately failure. We studied 166 patients in a single-surgeon-series of matched cohorts of patients who underwent total hip arthroplasties. Four separate groups were identified comprising of the posterior approach +/- navigation and the direct anterior approach +/- navigation...
July 17, 2017: Curēus
https://www.readbyqxmd.com/read/28934544/conjoint-tendon-release-in-direct-anterior-total-hip-arthroplasty-no-impact-on-patient-outcomes
#18
Reina Yao, James L Howard, Brent A Lanting
The direct anterior (DA) approach for total hip arthroplasty (THA) has become increasingly popular. However, femoral access can be more technically challenging in difficult cases as compared with other approaches. Conjoint tendon release can improve proximal femoral exposure, but its effect on patient function and pain has not been studied. This study evaluated the effect of conjoint tendon release on length of stay (LOS), inpatient pain medication requirements, and functional outcomes of patients undergoing DA THA...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28927566/low-rates-of-adverse-events-following-ambulatory-outpatient-total-hip-arthroplasty-at-a-free-standing-surgery-center
#19
Patrick C Toy, Matthew N Fournier, Thomas W Throckmorton, William M Mihalko
BACKGROUND: We proposed to determine the complication and hospital admission rates for patients with total hip arthroplasty (THA) done by a single surgeon in a stand-alone ambulatory surgical center with same-day discharge. Given the recent emphasis on bundled payments for a 90-day episode of care, this same time frame after surgery was chosen to determine patient outcomes. METHODS: The records of patients with THAs done through a direct anterior approach by a single surgeon at 2 separate ambulatory surgery centers were reviewed...
August 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28864031/comparison-of-wound-complications-and-deep-infections-with-direct-anterior-and-posterior-approaches-in-obese-hip-arthroplasty-patients
#20
Richard L Purcell, Nancy L Parks, John P Cody, William G Hamilton
BACKGROUND: The purpose of this study was to compare the posterior approach (PA) with the direct anterior approach (DAA) among obese and nonobese total hip arthroplasty patients to determine if obese DAA patients have a higher risk of infection or wound complications compared with obese PA patients. METHODS: We retrospectively evaluated 4651 primary total hip cases performed via anterior approach or PA between 2009 and 2015. Patients were divided into 4 study groups based on approach and body mass index (BMI): (1) DAA <35 kg/m(2), (2) DAA ≥35 kg/m(2), (3) PA <35 kg/m(2), and (4) PA ≥35 kg/m(2)...
August 4, 2017: Journal of Arthroplasty
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