Enhanced Early Outcomes with the Anterior Supine Intermuscular Approach in Primary Total Hip Arthroplasty

Berend, Keith R.; Lombardi, Adolph V.; Seng, Brian E.; Adams, Joanne B.

doi:10.2106/jbjs.i.00525

Cited by 179 publications

(121 citation statements)

References 19 publications

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“…Alecci et al in a review of 419 patients receiving either a standard lateral approach or a direct anterior approach (DAA) reported greater home discharge in the DAA group [38]. Furthermore, similar results have been reported by Berand et al after a retrospective review of 372 direct lateral approach and 258 anterior approaches concluding that more patients were discharged home in the anterior approach cohort [39].…”

Section: Total Hip Arthroplasty Approachsupporting

confidence: 60%

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Tarity¹,

Swall²

2017

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this manuscript is to review published literature over the last 5 years to assess recent trends and influencing factors regarding discharge disposition and post-discharge care following total joint arthroplasty. We evaluated instruments proposed to predict a patient's discharge disposition and summarize reports investigating the safety in sending more patients home by reviewing complications and readmission rates. Recent Findings Current literature supports decreased length of hospital stay and increased discharge to home with cost savings and stable readmission rates. Summary Surgeons with defined clinical pathways and those who shape patient expectations may more effectively control costs than those without defined pathways. Further research is needed analyzing best practices in care coordination, managing patient expectations, and costeffective analysis of home discharge while at the same time ensuring patient outcomes are optimized following total joint arthroplasty.

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Section: Total Hip Arthroplasty Approachsupporting

confidence: 60%

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Tarity¹,

Swall²

2017

Curr Rev Musculoskelet Med

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“…Some studies have compared recovery after THA performed through the direct anterior approach with other commonly used surgical approaches [1,4,21,22,30]. One study showed earlier normalization of Trendelenburg's sign, single-leg stance, and walking velocity and fewer patients using walking aids at 3 weeks with THA using the direct anterior approach compared to mini-posterior approach [22].…”

Section: Introductionmentioning

confidence: 99%

Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?

Rodríguez

Deshmukh

Rathod

et al. 2013

Clin Orthop Relat Res

194

162

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Background Newer surgical approaches to THA, such as the direct anterior approach, may influence a patient's time to recovery, but it is important to make sure that these approaches do not compromise reconstructive safety or accuracy. Questions/purposes We compared the direct anterior approach and conventional posterior approach in terms of (1) recovery of hip function after primary THA, (2) general health outcomes, (3) operative time and surgical complications, and (4) accuracy of component placement. Methods In this prospective, comparative, nonrandomized study of 120 patients (60 direct anterior THA, 60 posterior THAs), we assessed functional recovery using the VAS pain score, timed up and go (TUG) test, motor component of the Functional Independence Measure TM

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“…The anterior approach (AA): The approach used was the modiﬁed Smith-Peterson approach as described by Berend et al (2009). This approach uses the internervous plane between the tensor fascia lata and the sartorius muscles, and moves laterally to the rectus femoris for deep dissection.…”

Section: Methodsmentioning

confidence: 99%

Muscular strength after total hip arthroplasty

et al. 2015

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Background and purposeMinimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches.Patients and methodsIn a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up.ResultsDifferences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups.InterpretationThe posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

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Enhanced Early Outcomes with the Anterior Supine Intermuscular Approach in Primary Total Hip Arthroplasty

Cited by 179 publications

References 19 publications

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Current Trends in Discharge Disposition and Post-discharge Care After Total Joint Arthroplasty

Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?

Muscular strength after total hip arthroplasty

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