Primary Total Hip Arthroplasty with a Minimally Invasive Anterior Approach (original) (raw)
Related papers
Minimally Invasive Single-Incision Anterior Approach for Total Hip Arthroplasty-Early Results
Springer eBooks, 2004
A modified and limited Smith Petersen approach was used for prosthetic hip replacement. The exposure of the proximal femur required the use of a traction table. We operated on 49 patients: 15 of them underwent cemented bipolar hemiarthroplasty, and 34 had a total hip arthroplasty. Skin incision ranged from 6 to 11 cm (average 7.8 cm). Patients' subjective grading was evaluated according to a pain scale (0-10); early functional outcome was rated on postoperative days two, seven and 30 according to a functional scale of active flexion and abduction. Average active flexion on the second postoperative day was 68.4°, and active abduction 14.7°. Progressive increment of average active flexion and abduction was observed on day 7 (78.7°flexion-22.3°abduction) and day 30 (88.4°flexion-29.2°abduction). All patients were allowed progressive weightbearing depending on their postoperative pain. Most of them were fully weight bearing from the first day. This surgical approach, characterized by preservation of the muscular insertions, is associated with reduced postoperative pain and fast functional recovery.
Direct Anterior Approach for Total Hip Arthroplasty
Orthopedic Clinics of North America, 2009
Background: The purpose of this prospective cohort study was to clarify the safety and efficacy of total hip arthroplasty via the direct anterior approach in the supine position with a novel mobile traction table. Methods: The first experience of consecutive surgeries by a single surgeon using the direct anterior approach with a traction table is described with a two-year follow-up period. Of 121 patients, 100 patients without previous hip surgeries, severe deformity, or cemented implants were divided into two groups comprising the first 50 patients and the second 50 patients. Results: The implant survival rate was 99% at the two-year follow-up. Revision surgery was required for periprosthetic femoral fracture in one patient. The complication rate possibly related to the traction table was 5% (5 patients): three anterior dislocations, one periprosthetic femoral fracture, and one intraoperative perforation caused by femoral rasping. The complication rate tended to decrease in the second group compared to the first group (4% versus 6%). Mean surgical time (72.0 minutes versus 82.5 min, p = 0.027), rate of allogeneic blood transfusion (2% versus 24%, p = 0.001), and cup alignment in the safe zone (100% versus 88%, p = 0.027) were significantly improved in the second group compared to the first group. Conclusion: The direct anterior approach with a novel mobile traction table showed a positive learning curve for surgical time, rate of allogeneic blood transfusion, and cup alignment in the safe zone.
Outcome of primary total hip arthroplasty through direct anterior approach
International Journal of Orthopaedics Sciences, 2023
Background and Aim: Total hip arthroplasty is one of the most effective orthopedic procedures, adoption of minimally invasive approaches aims to enhance functional outcome and decrease the burden of patient's recovery. Aim of the study: Is to explain the surgical approach and to demonstrate the results that were attained and the complications that occurred. Methods: 30 hips were included in this study; they underwent a n anterior approach for hip replacement. Complications, surgical factors, and patient characteristics were all noted and assessed. Harris hip score was employed to assess the clinical results. Results: The mean clinical score was 96 points at 1 year follow-up compared to pre-operative score of 54. One patient had a revision while other complications were clinically insignificant. With carefully chosen patients, the direct anterior interval for hip replacement is a viable procedure that produces positive results.
Direct anterior approach for revision total hip arthroplasty
Annals of translational medicine, 2014
Revision total hip arthroplasty (THA) can be successfully performed through the direct anterior (DA) approach. Patient positioning, the surgical approach and specific instruments are important for obtaining adequate exposure. Acetabular exposure can be facilitated by capsular release and correct placement of retractors. Distal and proximal extension of the incision, as well as a femoral extended trochanteric osteotomy (ETO) can be performed to increase femoral exposure. The purposes of this article are to describe the DA approach, provide surgical techniques for revision THA through this approach, and describe the indications, contraindications and complications of this approach.
The Experince with Anterior Minimally Invasive Hip Surgery
Medical Archives, 2011
and Herzegovina 3 i introduction. When total hip arthroplasty (THA) is performed, the surgeon has to make a decision about the correct approach. Goals. In this research we will show our first experince with the implantation of endoprothesis for hip, using the method of anterior minimally invasive surgery. Methods. At the Traumatology clinic in Banja Luka, General hospital in Travnik, General hospital "Medicus" in Jelaha during the period between March 30th 2005 and June 1st 2009 53 hip prosthesis were implanted using minimally invasive Hueter approach, with the average length of incision of 7.3 cm. Subjects were 28 females and 25 males, with an average age of 56.8 years old. The reason for the surgery was hip arthrosis III i IV degree with 48 patients, while two patients had displastic arthrosis. One patient had arthritic changes following non-dislocated fracture of the acetabulum. One patient had arthritic changes of the femur. We implanted 50 non-cemented prosthesis, and tri comined (hybrid) prosthesis. Results. The orthopedic surgery was done with the use of two assistents and operating nurse, within 68 minutes on average while using on average 436 mL of transfused blood. Movements in an upright position with full weight bearing was done on post operative day one with 50 patients. Acute rehabilitation lasted 8.9 days on average. Full recovery was at 50 days on average, with achieved full range of motion and no use of assistive devices. The average Harris Hip Score (HHS) preoperativelly was 56, and three months postoperativelly it was 93. Five patients had complications: two with anterior displocation of the hip, one sealing of the shaft of the femur, and two infections; one superficial and the other deep. Superficial infection was treated with conservative therapy and the other patient had a removal of the prosthesis. Conslusion. Anterior minimally invasive surgery with THA is a method which gives a number of advantages for the patients, such as: lesser extent of operative trauma, shorter hospital stay, and quicker return to activities of daily living.
2021
The direct anterior approach (DAA) to the hip is gaining popularity worldwide. It has even become an integral part of orthopaedic training programs across the globe. This approach is well known for its long learning curve, which makes it challenging for residents and fellows to master in a short period of time during their rotations to different subspecialties. There is good evidence to support utilising this approach for a total hip arthroplasty (THA) as it affords patients an improvement in early recovery by way of better gait and kinematics compared to traditional approaches. This approach can be used to expedite patient's recovery with the aim of an early discharge in the form of an outpatient THA. The enhanced recovery program and day case hip arthroplasty using this approach is our standard practice and works perfectly with this muscle sparing approach. The aim of this article is to present a step-by-step guide for this approach for residents and fellows, and can be adopted by any surgeon working in a teaching setting. This is a full description of our institutional anterior approach to the hip that can be used for primary THA as well as revision cases using a dedicated traction table. This approach can be used for treating femoral neck fractures, periprosthetic infections and periprosthetic fractures. Femoral osteotomy for revision cases can be utilised in a similar fashion to other traditional approaches.