Direct anterior total hip arthroplasty: a retrospective study

Direct anterior total hip arthroplasty: a retrospective study

Authors

  • Giacomo Trivellin a:1:{s:5:"en_US";s:39:"Ospedale Pederzoli; Peschiera del Garda";}
  • Assad Assaker Ospedale Pederzoli, Peschiera del Garda
  • Andrea Vacchiano Ospedale Pederzoli, Peschiera del Garda
  • Dario Cominelli Ospedale Pederzoli, Peschiera del Garda
  • Andrea Meyer Ospedale Pederzoli, Peschiera del Garda

Keywords:

THA, Direct Anterior, Approach

Abstract

Background: The quest for less invasive surgical approaches for total hip arthroplasty has gained much attention recently. There is very little information regarding differences about the main surgical access. The purpose of this study was to collect data regarding patients’ subjective perceptions of the direct anterior hip arthroplasty, heterotopic ossification degrees, range of movement and complication and comparing these satisfaction results with the other surgical techniques. Methods: The study involved 51 patients operated in our Orthopedic clinic with direct anterior total hip arthroplasty between 2016 and 2017. We recorded and compared clinical and radiographic data at 1 year with anterolateral hip arthroplasty. Result: Only one patient described less than an 8/10 satisfaction; 5.45% of the patients restored the physiological ROM and 21.82 % lost only 5° of range of motion. According to Brooker Classification 58.33 % did not develop any Heterotopic Ossification. Conclusion: All standard approaches to the hip have been shown to be safe and efficacious, with particular advantages and disadvantages for each approach. DAA has some short term advantages like a faster recovery, less blood loss and less heterotopic ossification. Long term studies are required to demonstrate a cost benefit or quality of care advantage to other hip approaches. 

References

• 1 Hojer Karlse AP, Geisler A, Petersen PL, Mathiesen O, Dahl JB,. Postoperative pain, treatment after total hip arthroplasty ; a systematic review. Pain. 2015;156(1):8-30

• 2 Marques EM, Jones HE, Elsever KT, Pyke M, Blom AW, Beswick AD. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short and long-term effectiveness. BMC Muskoloskelet Disord 2014; 15:220

• 3 Kaunaratne S, Duan M, Pappas E, Fritsch B, Boyle R, Gupta S, Stalley P, Horsley M, Steffens D. The effectiveness of robotic hip and knee arthroplasty on patient-reported outcomes: a systematic review and meta-analysis. Int Orthop. 2018.[ Epub ahead of print]

• 4 Rachbauer F, Kain MS, Leunig M. The history of the anterior approach to the hip Orthop Clin North Am 2009;

• 5 Bender B, Nogler M, Hozack WJ. Direct anterior approach for total hip arthroplasty. Orthop Clin North Am 2009

• 6 Poehling-Monaghan KL, Kamath AF, Taunton MJ, Pagnano MW. Direct anterior versus miniposterior THA with the same advanced perioperative protocols: surprising early clinical results. Clin Orthop Relat Res 2015; 473: 623-631 [PMID: 25082624 DOI: 10.1007/s11999-014-3827-z]

• 7 Higgins BT, Barlow DR, Heagerty NE, Lin TJ. Anterior vs. posterior approach for total hip arthroplasty, a systematic review and meta-analysis. J Arthroplasty 2015; 30: 419-434 [PMID: 25453632 DOI: 10.1016/j.arth.2014.10.020]

• 8 Meneghini RM, Pagnano MW, Trousdale RT, Hozack WJ. Muscle damage during MIS total hip arthroplasty: Smith-Petersen versus posterior approach. Clin Orthop Relat Res 2006; 453: 293-298 [PMID: 17006366 DOI: 10.1097/01.blo.0000238859.46615.34]

• 9 Frye BM, Berend KR, Lombardi AV, Morris MJ, Adams JB. Do sex and BMI predict or does stem design prevent muscle damage in anterior supine minimally invasive THA? Clin Orthop Relat Res 2015; 473: 632-638 [PMID: 25337974 DOI: 10.1007/s11999-014- 3991-1]

• 10 Junich Nakamura, Shigeo Hagiwara, Sumihisa Orita. Direct asnterior approach for total hip arthrhoplasty with a novel mobile traction table - a prospective cohort study. Muscoloskeletal disorder 2017 DOI 10.1186/s12891-017-1427-2

• 11 Goebel S, Steinert AF, Schillinger J, Eulert J, Broscheit J, Rudert M, Nöth U. Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach. Int Orthop 2012; 36: 491-498 [PMID: 21611823 DOI: 10.1007/s00264-011-1280-0]

• 12 Kennon R, Keggi J, Zatorski LE, Keggi KJ (2004) Anterior approach for total hip arthroplasty: beyond the minimally invasive technique. J Bone Joint Surg Am 86-A(Suppl 2):91–97

• 13 Bertin KC, Rottinger H (2004) Anterolateral mini-incision hip replacement surgery: a modified Watson-Jones approach. Clin Orthop Relat Res 429:248–255

• 14 Goldstein WM, Branson JJ, Berland KA, Gordon AC (2003) Minimal-incision total hip arthroplasty. J Bone Joint Surg Am 85-A(Suppl 4):33–38

• 15 Moore AT (1959) The Moore self-locking vitallium prothesis in fresh femoral neck fractures: a new low posterior approach (the southern exposure). AAOS Instr Course Lect 16:309

• 16 Berger RA (2004) Mini-incision total hip replacement using an anterolateral approach: technique and results. Orthop Clin North Am 35(2):143–151. doi:10.1016/S0030-5898(03)00111-1

• 17 Berger RA, Duwelius PJ (2004) The two-incision minimally invasive total hip arthroplasty: technique and results. Orthop Clin North Am 35(2):163–172. doi:10.1016/S0030-5898(03)00110-X

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Published

30-05-2020

How to Cite

1.
Trivellin G, Assaker A, Vacchiano A, Cominelli D, Meyer A. Direct anterior total hip arthroplasty: a retrospective study. Acta Biomed [Internet]. 2020 May 30 [cited 2024 Jul. 27];91(4-S):98-102. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/9227