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Direct anterior hip arthroplasty

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https://www.readbyqxmd.com/read/29656970/predictability-of-pelvic-tilt-during-total-hip-arthroplasty-using-a-traction-table
#1
Paul S Roettges, Jack R Hannallah, Jordan L Smith, John T Ruth
BACKGROUND: Pelvic positioning during total hip arthroplasty (THA) affects functional position of the acetabular component. We sought to evaluate whether preoperative pelvic tilt correlated with intraoperative pelvic tilt while positioned on a traction table for direct anterior THA and furthermore to evaluate whether there was a consistent and predictable effect on pelvic tilt while positioned for surgery. METHODS: We evaluated the sagittal spinopelvic preoperative standing and supine pelvic tilt radiographic measurements as compared with intraoperative measurements of 25 patients...
March 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29622494/evaluation-of-the-learning-curve-when-transitioning-from-posterolateral-to-direct-anterior-hip-arthroplasty-a-consecutive-series-of-1000-cases
#2
Andrea H Stone, Udai S Sibia, Ryan Atkinson, Timothy R Turner, Paul J King
BACKGROUND: The direct anterior approach (DAA) for primary hip replacement has been gaining more attention and widespread use in recent years. There are a number of published studies evaluating the learning curve when a surgeon changes technique; these studies typically look at complications during the initial cases. This study examines procedure and total operating room (OR) time along with all complications for a surgeon transitioning from the posterolateral approach (PA) to DAA. METHODS: A retrospective review of a single surgeon series of 1000 initial DAA procedures...
March 8, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29615378/intraoperative-psoas-compartment-block-vs-preoperative-fascia-iliaca-block-for-pain-control-after-direct-anterior-total-hip-arthroplasty-a-randomized-controlled-trial
#3
Clayton R Perry, Adam M Fahs, Michael D Kurdziel, Denise M Koueiter, Randy J Fayne, James J Verner
BACKGROUND: Modern joint arthroplasty protocols place an emphasis on minimizing patient-reported postoperative pain while minimizing opioid consumption. The use of multimodal pain management protocols has been reported to improve patient outcomes and satisfaction after total hip arthroplasty. METHODS: In a prospective, single-surgeon trial, 50 patients undergoing primary direct anterior approach total hip arthroplasty were randomized to receive a preoperative fascia iliaca compartment block (FICB) or an intraoperative surgeon-delivered psoas compartment block (PCB)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29613926/motor-evoked-potential-analysis-of-femoral-nerve-status-during-the-direct-anterior-approach-for-total-hip-arthroplasty
#4
Tetsuro Ishimatsu, Koichi Kinoshita, Jun Nishio, Jun Tanaka, Satohiro Ishii, Takuaki Yamamoto
BACKGROUND: During the direct anterior approach for total hip arthroplasty, a retractor is placed on the anterior wall of the acetabulum to retract the iliopsoas muscle. This step with the retractor has been reported to put the patient at risk for femoral nerve damage. The present study aimed to clarify the effects of the anterior acetabular retractor on the status of the femoral nerve during the direct anterior approach on the basis of transcranial motor-evoked potential (MEP) analysis...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29576639/total-hip-arthroplasty-by-the-direct-anterior-approach-using-a-neck-preserving-stem-safety-efficacy-and-learning-curve
#5
Aditya Khemka, Omar Mograby, Sarah J Lord, Zelda Doyle, Munjed Al Muderis
Background: The concept of femoral neck preservation in total hip replacement (THR) was introduced in 1993. It is postulated that retaining cortical bone of the femoral neck offers triplanar stability, uniform stress distribution, and accommodates physiological anteversion. However, data on safety, efficacy and learning curve are lacking. Materials and Methods: We prospectively assessed all patients who were operated for a THR with a short neck preserving stem (MiniHip) between 2012 and 2014...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29560393/the-direct-anterior-approach-for-acetabular-augmentation-in-primary-total-hip-arthroplasty
#6
Erin Honcharuk, Stephen Kayiaros, Lee E Rubin
Addressing acetabular bone defects can be difficult and depends on the amount of bone loss. Augments, either with bone or highly porous metals, are options that still allow the use of a hemispherical cup. Almost all previous research and publication on acetabular augments have focused on revision hip arthroplasty utilizing either a modified lateral or a posterolateral surgical approach. We describe 3 cases of augmenting acetabular bone defects through a direct anterior approach for primary total hip arthroplasty...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29560392/muscle-activation-pattern-during-gait-and-stair-activities-following-total-hip-arthroplasty-with-a-direct-anterior-approach-a-comprehensive-case-study
#7
Swati Chopra, Michael Taunton, Kenton Kaufman
Muscle activation following total hip arthroplasty with a direct anterior approach has not previously been reported in the literature. This case report details the electromyography outcome of a 60-year-old male patient with unilateral direct anterior approach-total hip arthroplasty during walking and stair activities. Outcome reports the continuation of altered muscle activation 12 months postoperatively, even with a good clinical outcome.
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29555492/psoas-compartment-block-vs-periarticular-local-anesthetic-infiltration-for-pain-management-after-anterior-total-hip-arthroplasty-a-prospective-randomized-study
#8
Adam M Fahs, Denise M Koueiter, Michael D Kurdziel, Kristine A Huynh, Clayton R Perry, James J Verner
BACKGROUND: The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined. METHODS: In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29523974/preservation-of-the-articular-capsule-and-short-lateral-rotator-in-direct-anterior-approach-to-total-hip-arthroplasty
#9
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
INTRODUCTION: In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate...
March 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29520467/outcomes-after-revision-of-metal-on-metal-hip-resurfacing-to-total-arthroplasty-using-the-direct-anterior-approach
#10
Victoire Bouveau, Thomas-Xavier Haen, Joel Poupon, Christophe Nich
BACKGROUND: Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. METHODS: Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs)...
March 8, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29511824/minimally-invasive-total-hip-arthroplasty-using-hueter-s-direct-anterior-approach
#11
Pascal Moreau
For many years the Hueter anterior approach has been performed exclusively in Paris. Robert and Jean Judet described it for the first time in 1950 in relation to total hip arthroplasty. They started using an orthopaedic surgery table in 1985. The approach was only taught within the capital's orthopaedic units and was relatively unknown before. In the last 10 years there has been widespread renewed interest in this approach which preserves the muscles. The technique is described in detail with its tricks and risks...
March 6, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29502965/similar-superior-patient-reported-outcome-measures-for-anterior-and-posterolateral-approaches-after-total-hip-arthroplasty-postoperative-patient-reported-outcome-measure-improvement-after-3-months-in-12-774-primary-total-hip-arthroplasties-using-the-anterior
#12
Rinne M Peters, Loes W A H van Beers, Liza N van Steenbergen, Julius Wolkenfelt, Harmen B Ettema, Bas L E F Ten Have, Paul C Rijk, Martin Stevens, Sjoerd K Bulstra, Rudolf W Poolman, Wierd P Zijlstra
BACKGROUND: Patient-reported outcome measures (PROMs) are used to evaluate the outcome of total hip arthroplasty (THA). We determined the effect of surgical approach on PROMs after primary THA. METHODS: All primary THAs, with registered preoperative and 3 months postoperative PROMs were selected from the Dutch Arthroplasty Register. Based on surgical approach, 4 groups were discerned: (direct) anterior, anterolateral, direct lateral, and posterolateral approaches...
March 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29500087/the-use-of-fluoroscopy-during-direct-anterior-hip-arthroplasty-powerful-or-misleading
#13
Christopher R James, Blake E Peterson, Julia R Crim, James L Cook, Brett D Crist
BACKGROUND: Direct anterior approach total hip arthroplasty (THA) with fluoroscopic assistance is growing in popularity. Variables such as pelvic tilt, c-arm technique, and patient positioning can affect the perceived fluoroscopic view. This study evaluates the effect of these variables on the position of the acetabular component. METHODS: Forty-one hips in 40 patients undergoing direct anterior arthroplasty THA with fluoroscopic assistance underwent routine postoperative radiographs and postoperative pelvic computed tomography scan...
February 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29492612/efficacy-of-oral-tranexamic-acid-on-blood-loss-in-primary-total-hip-arthroplasty-using-a-direct-anterior-approach-a-prospective-randomized-controlled-trial
#14
HaiYan Zhao, MaoYing Xiang, YaYi Xia, Xiaojun Shi, Fu-Xing Pei, PengDe Kang
BACKGROUND: Tranexamic acid (TXA), delivered intravenously or topically, has been shown to reduce blood loss, the need for transfusion, and relevant healthcare costs when administered in primary standard total hip arthroplasty (THA). Whether the same is true of oral TXA is unclear, the purpose of this study was to determine if oral tranexamic acid is equivalent to intravenous TXA in the case of patients undergoing THA via the direct anterior approach. METHODS: In this prospective randomized controlled trial, 120 patients undergoing primary THA by the direct anterior approach were randomized to receive oral TXA (two doses of 20 mg/kg), intravenous TXA (two doses of 15 mg/kg), or no TXA...
February 28, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29482087/the-impact-of-hip-implant-alignment-on-muscle-and-joint-loading-during-dynamic-activities
#15
Casey A Myers, Peter J Laz, Kevin B Shelburne, Dana L Judd, Daniel N Huff, Joshua D Winters, Jennifer E Stevens-Lapsley, Paul J Rullkoetter
BACKGROUND: Component alignment is an important consideration in total hip arthroplasty. The impact of changes in alignment on muscle forces and joint contact forces during dynamic tasks are not well understood, and have the potential to influence surgical decision making. The objectives of this study were to assess the impact of femoral head/stem and cup component placement on hip muscle and joint contact forces during tasks of daily living and to identify which alignment parameters have the greatest impact on joint loading...
February 14, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29439894/early-failure-of-primary-total-hip-arthroplasty-is-surgical-approach-a-risk-factor
#16
Marc R Angerame, Thomas K Fehring, John L Masonis, J Bohannon Mason, Susan M Odum, Bryan D Springer
BACKGROUND: In an era of innovation in surgical approaches for total hip arthroplasty (THA), there is concern for increasing trends of early failure. The purpose of this study is to evaluate the incidence of early failure of primary THA stratified by surgical approach. METHODS: A retrospective review was performed on consecutive primary THAs completed from 2007 to 2014 at a high-volume center. THAs were stratified by surgical approach. Only the direct anterior (DAA) and posterior approaches (PA) were included...
February 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29398996/scaling-marker-position-determines-the-accuracy-of-digital-templating-for-total-hip-arthroplasty
#17
Austin J Ramme, Nina D Fisher, Jonathan Egol, Gregory Chang, Jonathan M Vigdorchik
Background: Digital templating systems foster patient-specific measurements for preoperative planning. Questions/Purposes: We aim (1) to verify the accuracy of a templating system, (2) to describe the effects of scaling marker position on the accuracy of digital templating of the hip, and (3) to provide a practical guide for scaling marker position using patient body mass index (BMI). Methods: A scaling sphere was placed in five positions along the anterior-posterior axis of an acetabular implant and pelvis phantom, and x-rays were obtained...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29335832/lateral-trochanteric-pain-following-total-hip-arthroplasty-radiographic-assessment-of-altered-biomechanics-as-a-potential-aetiology
#18
Ali Abdulkarim, Cathy Keegan, Raazi Bajwa, Eoin Sheehan
INTRODUCTION: Lateral trochanteric pain (LTP) complicates up to 17% of cases of total hip arthroplasty (THA). Studies have refuted underlying trochanteric bursitis. Restoration of the femoral offset and reproduction of the natural femoral centre of rotation are important in successful arthroplasty. LTP is believed to be associated with their alteration. AIM: The aim of our study was to evaluate the effect of femoral offset and centre of rotation on the incidence of LTP post-THA...
January 15, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29322899/is-the-pelvis-stable-during-supine-total-hip-arthroplasty
#19
S M Shah, W L Walter, J Ngo
Intra- operative changes in pelvic position during total hip arthroplasty (THA) can affect acetabular orientation. We evaluated these changes during supine THA using a proprietary mobile application called PelvicTracker. Twenty- two patients undergoing THA using direct anterior approach were included in the study. In the sagittal plane, the pelvis was extended (anterior tilt) as compared to the start of surgery in 19/ 22 hips at the time of cup implantation (mean extension: 3.1°; range: 1°-6°). In the transverse plane, the pelvis was rolled to the opposite side of surgery in 12 hips (mean roll: 2...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29310681/comparison-of-outcome-measures-and-complication-rates-following-three-different-approaches-for-primary-total-hip-arthroplasty-a-pragmatic-randomised-controlled-trial
#20
Adrian J Talia, Cassandra Coetzee, Oren Tirosh, Phong Tran
BACKGROUND: Total hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty. METHODS/DESIGN: This is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre...
January 8, 2018: Trials
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