Dislocation After Total Hip Arthroplasty Using Hueter Anterior Approach

Sariali, Elhadi; Léonard, Philippe; Mamoudy, P.

doi:10.1016/j.arth.2007.04.003

Cited by 175 publications

(106 citation statements)

References 19 publications

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“…However, this cohort included his learning curve, suggesting that 3D planning may help decrease the intra-operative complication rate in the early experience of DAA. Indeed, with respect to the intra-operative complications, the learning curve varies according to the authors from 20 [18] to 200 [1,5]. In our future work, we will replicate this study with a variety of surgeons with different skill levels.…”

Section: Discussionmentioning

confidence: 93%

“…The direct anterior approach (DAA) is an attractive option for total hip arthroplasty (THA) in order to decrease the dislocation rate [1] and to achieve a quicker rehabilitation [2]. However, this surgical technique presents a longer learning curve and a higher complications rate, especially on the femoral side including femoral stem malposition [3] and intraoperative femur fractures [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Sariali

Catonné

Pascal‐Moussellard

2016

International Orthopaedics (SICOT)

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Purpose The direct anterior approach is an attractive option for total hip arthroplasty (THA) in order to achieve a quicker rehabilitation. However, this surgical technique presents a longer learning curve and a higher complications rate compared with the standard approach. We investigated whether three-dimensional (3D) planning anticipated the surgical difficulties and helped to achieve a low complications rate with respect to intra-operative complications, dislocation risk and lower limb discrepancy (LLD). Methods One hundred and fifty-four consecutive patients underwent a primary cementless THA using a direct anterior approach. A 3D planning was performed in order to anticipate the difficulties that may be encountered regarding femur perforation or fracture, dislocation and LLD. All patients were assessed at a mean five years' follow-up. Results No false route and no fracture occurred at the time of surgery. All the surgical difficulties were anticipated. A motorised reaming procedure of the femur was required in six patients because of a very dense bone or a narrow femur. A retroverted neck was used in 7 % of patients because of a torsional abnormality and enabled an increase in stability. The real implant sizes were the same as the ones planned in 97 % for the cup, 96 % for the stem and 100 % for the neck. At five years' follow-up, no dislocation occurred, no patient complained about LLD and excellent clinical outcomes were achieved. Conclusions This study demonstrates that 3D pre-operative planning-guided THA through a minimally invasive direct anterior approach is a safe and accurate procedure.Level of Evidence: Level IV

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Sariali

Catonné

Pascal‐Moussellard

2016

International Orthopaedics (SICOT)

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“…The direct-anterior Hueter approach [32] is a modification of the traditional Smith-Petersen approach [18,44] in the interval between the rectus femoris and tensor fascia lata muscles and often uses a specialized table to allow for intraoperative anterior exposure and positioning of the hip [28,29]. Numerous authors have reported low dislocation rates and rapid early functional recovery [1,29,31,33,36,40,46] with this approach. However, some studies have shown higher surgical blood loss and complication rates [6,47], particularly for less-experienced surgeons [16,43] or for patients who are obese [39].…”

Section: Introductionmentioning

confidence: 99%

Does Surgical Approach Affect Patient-reported Function After Primary THA?

Graves

Dropkin

Keeney

et al. 2016

Clinical Orthopaedics &Amp; Related Research

112

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Background Total hip arthroplasty (THA) relieves pain and improves physical function in patients with hip osteoarthritis, but requires a year or more for full postoperative recovery. Proponents of intermuscular surgical approaches believe that the direct-anterior approach may restore physical function more quickly than transgluteal approaches, perhaps because of diminished muscle trauma. To evaluate this, we compared patient-reported physical function and other outcome metrics during the first year after surgery between groups of patients who underwent primary THA either through the direct-anterior approach or posterior approach. Questions/purposes We asked: (1) Is a primary THA using a direct-anterior approach associated with better patient-reported physical function at early postoperative times (1 and 3 months) compared with a THA performed through the posterior approach? (2) Is the direct-anterior approach THA associated with shorter operative times and higher rates of noninstitutional discharge than a posterior approach THA? Methods Between

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“…leg length restoration, with no increase in dislocation rates [32,33,41,53,59,61]. In smaller community hospital settings, concern has been raised regarding trochanteric fractures; Woolson and associates reported a 5.7% incidence [66] in their series of anterior approach THA.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

205

145

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Dislocation After Total Hip Arthroplasty Using Hueter Anterior Approach

Cited by 175 publications

References 19 publications

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Three-dimensional planning-guided total hip arthroplasty through a minimally invasive direct anterior approach. Clinical outcomes at five years’ follow-up

Does Surgical Approach Affect Patient-reported Function After Primary THA?

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

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