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Direct anterior hip arthroplasty

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https://www.readbyqxmd.com/read/29048696/the-direct-anterior-minimal-invasive-approach-in-total-hip-replacement-a-prospective-departmental-study-on-the-learning-curve
#1
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
#2
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: We 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)...
October 15, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28835239/prospective-comparison-of-the-anterior-and-lateral-approach-in-hemiarthroplasty-for-hip-fractures-a-study-protocol
#11
Max P L van der Sijp, Inger B Schipper, Stefan B Keizer, Pieta Krijnen, Arthur H P Niggebrugge
BACKGROUND: The Direct Anterior Approach (DAA) is an alternative approach to the currently most used Lateral Approach (LA) for hip replacement in femoral neck fracture patients. Compared to the LA, the DAA minimizes soft tissue damage. Sparing muscle tissue may facilitate early and improved postoperative mobility. It may also be associated with fewer complications, increased quality of life and lower 1-year mortality. The aim of this study is to compare postoperative complications, hip function and patient mobility after hemiarthroplasty via the anterior or lateral approach following a displaced femoral neck fracture...
August 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28819343/mid-term-migration-of-a-cementless-porous-acetabular-cup-a-5%C3%A2-year-radiostereometric-analysis
#12
Kjell G Nilsson, Annika Theodoulou, Graham Mercer, Stephen J Quinn, Jeganath Krishnan
PURPOSE: The aim of the study was to determine the 5 year migratory and wear patterns, adverse events and clinical outcomes of a cementless, porous acetabular cup. METHODS: RSA imaging of a cohort of 11 patients was retrospective analysed at 5 years post Total Hip Arthroplasty (THA). Changes in pain, function and symptoms of the hip at 5 years post-THA were compared to preoperative and 2 year postoperative assessments on the Harris Hip Score (HHS) and Hip dysfunction and Osteoarthritis Outcome Score (HOOS)...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790465/surgical-approaches-for-total-hip-arthroplasty
#13
Vincent M Moretti, Zachary D Post
Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches. A review of outcomes and complications for each approach are also provided. Each approach has its own unique advantages and disadvantages, but all can be safely and successful utilized for THA...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28781017/differences-in-femoral-head-penetration-between-highly-cross-linked-polyethylene-cemented-sockets-and-uncemented-liners
#14
Daigo Morita, Taisuke Seki, Yoshitoshi Higuchi, Yasuhiko Takegami, Naoki Ishiguro
BACKGROUND: This study aimed at investigating differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets and uncemented liners during 5 years postoperatively. METHODS: Ninety-six patients (106 hips) with a mean age of 64.4 (range, 35-83) years underwent total hip arthroplasty using a HXLPE cemented socket or liner and were respectively divided into cemented (35 patients [37 hips]) and uncemented (61 patients [69 hips]) groups...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780222/posterolateral-vs-direct-anterior-approach-in-total-hip-arthroplasty-polada-trial-a-randomized-controlled-trial-to-assess-differences-in-serum-markers
#15
Kyrill Rykov, Inge H F Reininga, Maurits S Sietsma, Bas A S Knobben, Bas L E F Ten Have
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty has claimed to be a true tissue-sparing minimally invasive approach that has less tissue damage and a faster recovery when compared to the posterolateral approach (PLA). The aim of this randomized controlled trial is to measure the differences in serum markers and functional outcomes between the DAA and PLA for total hip arthroplasty. METHODS: Forty-six patients were prospectively included and randomized for either the DAA (n = 23) or PLA (n = 23)...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28731487/intraoperative-fluoroscopy-with-a-direct-anterior-approach-reduces-variation-in-acetabular-cup-abduction-angle
#16
Gens P Goodman, Nitin Goyal, Nancy L Parks, Robert H Hopper, William G Hamilton
INTRODUCTION: The purpose of this study was to compare acetabular cup position for 2 cohorts of total hip arthroplasty (THA) patients who had a direct anterior approach. METHODS: 100 THA cases were performed with an anterior approach using intraoperative fluoroscopy (IF) to aid in cup positioning. Another group of 100 cases underwent THA with an anterior approach without the use of any fluoroscopy. Postoperative abduction and anteversion angles were measured using Martell's hip analysis software...
July 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28704684/root-mean-square-of-lower-trunk-acceleration-during-walking-in-patients-with-unilateral-total-hip-replacement
#17
Osamu Wada, Tsuyoshi Asai, Yoshinori Hiyama, Shingo Nitta, Kiyonori Mizuno
Although several studies have described abnormal trunk motion before and after total hip arthroplasty (THA) surgery, few studies have examined trunk motion using accelerometry. The aim of this study was to determine whether abnormal trunk motion persisted after THA using accelerometry. A total of 24 female patients (61.0±6.9years) and 20 healthy female subjects (59.9±6.8years) participated in this study. Patients were assessed at 1 month prior to surgery and 12 months after surgery. Trunk acceleration during gait was measured using a triaxial accelerometer attached to the L3 spinous process...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28702750/function-and-activity-after-minimally-invasive-total-hip-arthroplasty-compared-to-a-healthy-population
#18
Eberhard von Rottkay, Lars Rackwitz, Maximilian Rudert, Ulrich Nöth, Johannes Christian Reichert
PURPOSE: The aim of the present study was to compare the daily activity and functionality in a patient cohort 12 months after total hip arthroplasty (THA) using a direct anterior approach with a healthy non-operated control population. METHODS: Sixty-four patients who underwent THA and 59 healthy individuals (control) were assessed regarding their daily activity and joint functionality utilizing the Harris hip score (HHS), the extra short musculoskeletal functional assessment questionnaire (XSFMA), the Short Form 36 (SF-36) health survey and a Stepwatch™ Activity Monitor (SAM)...
July 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28662957/comparison-of-early-functional-recovery-after-total-hip-arthroplasty-using-a-direct-anterior-or-posterolateral-approach-a-randomized-controlled-trial
#19
Hai-Yan Zhao, Peng-De Kang, Ya-Yi Xia, Xiao-Jun Shi, Yong Nie, Fu-Xing Pei
BACKGROUND: Controversy exists as to whether early functional outcomes differ after total hip arthroplasty performed using the direct anterior approach (DAA) or the posterolateral approach (PLA). METHODS: One hundred twenty patients were enrolled in this study and were divided into 2 groups based on surgical approach. Group A included patients who had a total hip arthroplasty with a DAA, whereas group B included those with a PLA. Patients were randomized into the DAA or PLA groups (n = 60), and perioperative and postoperative outcomes were recorded...
November 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641967/fluoroscopically-guided-acetabular-component-positioning-does-it-reduce-the-risk-of-malpositioning-in-obese-patients
#20
Raul G Gosthe, Juan C Suarez, Colin A McNamara, Cecilia Calvo, Preetesh D Patel
BACKGROUND: Obesity has been described as an independent risk factor for acetabular component malpositioning. The purpose of this study was to determine if this could be overcome by use of fluoroscopic navigation in total hip arthroplasty (THA). METHODS: The first, postoperative, standing, anteroposterior pelvis radiographs from 1599 consecutive patients who underwent fluoroscopic-guided THAs via anterior approach during a six-year period were obtained. We retrospectively reviewed this prospectively collected data...
May 5, 2017: Journal of Arthroplasty
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