Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results

Connolly, Keith P; Kamath, Atul F.

doi:10.5312/wjo.v7.i2.94

Cited by 59 publications

(42 citation statements)

References 42 publications

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“…However, there is a trend towards performing more arthroplasty surgery using anteriorly placed incisions [ 25 , 26 ] with or without mini-incision. The main advantage of anteriorly based approaches is that they are tissue sparring by avoiding cutting major muscles and reduces the dislocation rate [ 27 – 31 ]. Surgery with mini-incision technique is thought to reduce the tissue damage even more and promote faster recovery [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection

et al. 2016

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Propionibacterium acnes is well-established as a possible etiologic agent of prosthetic joint infections (PJIs). Other Propionibacterium spp. have occasionally been described as a cause of PJIs, but this has not previously been the case for P. avidum despite its capacity to form biofilm. We describe two patients with prosthetic hip joint infections caused by P. avidum. Both patients were primarily operated with an anteriorly curved skin incision close to the skin crease of the groin, and both were obese. Initial treatment was performed according to the DAIR procedure (debridement, antibiotics, and implant retention). In case 1, the outcome was successful, but in case 2, a loosening of the cup was present 18 months post debridement. The P. avidum isolate from case 1 and two isolates from case 2 (obtained 18 months apart) were selected for whole genome sequencing. The genome of P. avidum obtained from case 1 was approximately 60 kb larger than the genomes of the two isolates of case 2. These latter isolates were clonal with the exception of SNPs in the genome. All three strains possessed the gene cluster encoding exopolysaccharide synthesis.P. avidum has a pathogenic potential and the ability to cause clinically relevant infections, including abscess formation, in the presence of foreign bodies such as prosthetic joint components. Skin incision in close proximity to the groin or deep skin crease, such as the anteriorly curved skin incision approach, might pose a risk of PJIs by P. avidum, especially in obese patients.

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Section: Discussionmentioning

confidence: 99%

Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection

et al. 2016

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“…The observation groups presented outstanding improvements in terms of the height of fused segment and cervical curvature compared with the control group (P<0.05). These results validated the clinical application value of ACDF in improving its comprehensive therapeutic effect on patients with adjacent two-segment CSM comprehensively [10].…”

Section: Discussionmentioning

confidence: 49%

Clinical effect of two anterior approaches to adjacent two-segment cervical spondylotic myelopathy

Li¹,

Gou²,

Bai³

et al. 2018

biomedicalresearch

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Objective: This paper discusses the clinical effects of two anterior approaches to adjacent two-segment Cervical Spondylotic Myelopathy (CSM). Methods: A total of 108 patients with adjacent two-segment CSM who were admitted to our hospital from November 2015 to January 2017 were selected and divided randomly into control and observation groups according to different anterior approaches. The control group (46 cases) used single-segment Anterior Centrum Corpectomy Fusion (ACCF), whereas the observation group (62 cases) adopted twosegment Anterior Cervical Decompression and Fusion (ACDF). Indexes in perioperative period, visual analog scale score, JOA score, height of fused segment, and cervical curvature of the two groups were observed and compared. Results: The observation group achieves a significant increase in the amount of bleeding and time of operation compared with the control group (P<0.05). No significant difference is found between the two groups in terms of length of stay (P>0.05). The observation group fails to achieve significant improvement compared with the control group in terms of VAS and JOA scores (P>0.05). By contrast, the observation group shows significant improvements in the height of fused segment and cervical curvature than the control group (P<0.05). Conclusion: Reasonable selection of ACDF in clinical treatment of adjacent two-segment CSM can reduce the amount of bleeding during the operation significantly, thereby improving the cervical curvature and height of fused segment.

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“…Many studies have shown that this approach allows early recovery of muscle strength and improved walking ability in the early postoperative period [5–7]. Sariali postulated that an anterior approach achieves these results because it does not require cutting any muscles or tendons [8].…”

Section: Discussionmentioning

confidence: 99%

Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty

Kanda

Obayashi

Mogami

et al. 2018

Eur J Orthop Surg Traumatol

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IntroductionIn 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.MethodsWe evaluated muscle strength recovery by measuring the maximum width of the internal obturator muscle on CT images (GE-Healthcare Discovery CT 750HD). We compared the maximum width of the muscle belly preoperatively versus 10 days and 6 months postoperatively. As clinical evaluations, we also investigated the range of motion of the hip joint, hip joint function based on the Japanese Orthopaedic Association hip score (JOA score), and the dislocation rate 6 months after surgery.ResultsThe width of the internal obturator muscle increased significantly from 15.1 ± 3.1 mm before surgery to 16.4 ± 2.8 mm 6 months after surgery. The JOA score improved significantly from 50.8 ± 15.1 points to 95.6 ± 7.6 points. No dislocations occurred in this study.ConclusionsWe cut only the posterosuperior articular capsule and protected the internal obturator muscle to preserve muscle strength. We repaired the entire posterosuperior and anterior articular capsule. These treatments increase joint stability in the early postoperative period, thus reducing the dislocation rate.Level of evidenceTherapeutic, Level IV.

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Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results

Cited by 59 publications

References 42 publications

Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection

Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection

Clinical effect of two anterior approaches to adjacent two-segment cervical spondylotic myelopathy

Preservation of the articular capsule and short lateral rotator in direct anterior approach to total hip arthroplasty

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