Simultaneous Bilateral Supine Anterior Approach Total Hip Arthroplasty: Evaluation of Early Complications and Short-Term Rehabilitation

Mast, Nicholas H.; Muñoz, M Toca; Matta, Joel M.

doi:10.1016/j.ocl.2009.04.002

Cited by 27 publications

(21 citation statements)

References 21 publications

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“…Approximately 15%-20% of patients presenting for consideration of total hip arthroplasty (THA) present with bilateral disease (1–3). Simultaneous bilateral THA refers to surgery being performed on both hip joints during a single trip to the operating room with one anesthesia event.…”

Section: Introductionmentioning

confidence: 99%

“…Proposed advantages include a theoretical benefit of a single operative event, cost savings (1–4), shorter total postoperative hospitalisation, (2–6) and decreased time to maximal functional outcome (7). Possible disadvantages include prolonged operative duration (2, 5, 6, 8), increased estimated blood loss (EBL) and need for blood transfusion (2, 3, 5, 6, 9, 10), increased rates of venous thromboembolic events (VTE) (10, 11), higher utilisation of inpatient rehabilitation services (6, 9), increased rates of subsequent and revision hip surgeries (3), and decreased reimbursement rates (1). Published reports are inconsistent regarding these claims and include surgical approaches performed in the lateral decubitus position that require repositioning the patient, repeat prepping and draping, and exposure of the fresh surgical wound to pressure and manipulation while performing the contralateral THA.…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Analysis of the Merits and Challenges Associated with Simultaneous Bilateral THA using the Direct Anterior Approach

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of the Merits and Challenges Associated with Simultaneous Bilateral THA using the Direct Anterior Approach

et al. 2016

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“…Rapid recovery after DAA also might limit postoperative loss of hip muscle force and mass [4]. Some advocates suggest that DAA may allow further broadening of indications for THA including onestage bilateral THA [10] and can reduce hospitalization and treatment costs [3].…”

Section: Introductionmentioning

confidence: 99%

Skin Crease ‘Bikini’ Incision for Anterior Approach Total Hip Arthroplasty: Surgical Technique and Preliminary Results

Leunig

Faas

Knoch

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The direct anterior approach for THA allows implantation through an internervous plane without muscle detachment from bone. However, the classic longitudinal skin incision does not follow the anatomic skin creases and can result in scar widening. We therefore modified our incision technique to a short oblique skin incision following the anatomic skin crease of the groin.Questions/purposes We sought to determine whether (1) the oblique incision leads to improved scar results compared with the longitudinal incision, (2) functional and pain scores are similar between the two approaches, and (3) the new incision is safe with respect to complications, blood loss, implant position, and lateral femoral cutaneous nerve (LFCN) symptoms. Methods Fifty-nine patients underwent THAs using either the classic (n = 33) or the new oblique incision (n = 26). At 6 months after surgery, we compared objective and subjective scar results, WOMAC, Oxford Hip and UCLA scores, blood loss, cup inclination, and the presence of LFCN symptoms between both groups.

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“…To address the difficulties in femoral exposure, the use of a dedicated surgical table allowing for extension of the operative limb and rigid positioning of the femur has been advocated [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] ]. Although the DA approach can also be performed on a standard operating room (OR) table, the setup requires bilateral draping of the lower extremities, an extra scrubbed assistant to position both extremities throughout the procedure, and sometimes the use of a table-mounted femoral elevator, making it a less-attractive option in the eyes of some surgeons [ 2 , 8 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiographic Outcomes after Direct Anterior Approach Total Hip Arthroplasty Using Two Specialized Surgical Tables

et al. 2020

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Background Specialized tables for direct anterior (DA) approach total hip arthroplasty (THA) have required an unscrubbed assistant for manipulation of the operative limb. A novel surgical table attachment designed for the DA approach is fully surgeon controlled and partially automated. The purpose of this study is to compare the clinical outcomes in patients who underwent THA through a DA approach with an assistant-controlled vs the surgeon-controlled (SC) table. Methods This is a retrospective study of 343 patients who underwent primary THA between January 2017 and October 2017. Two cohorts were established based on the surgical table used. Surgical and clinical data included the surgical time, length of stay, presence of pain (groin, hip, or thigh pain) at latest follow-up, and revision for any reason. Immediate postoperative radiographs were compared with latest follow-up radiographs to assess for leg length discrepancy, stem alignment, and stem subsidence. Results One hundred sixty-seven (48.7%) cases were performed using the assistant-controlled table, and 176 (51.3%) cases were performed using the SC table. The surgical time was significantly greater for surgeries using the SC table (70.2 minutes vs 66.1 minutes, P < .001). Neither group experienced any intraoperative fractures or postoperative dislocations. There were no significant differences in any other clinical or radiographic outcomes. Conclusions Although the surgical time with the self-controlled table was longer by approximately 4 minutes, this discrepancy disappeared with progression through the learning curve. In our experience, the SC table allows for greater autonomy for the operating surgeon and eliminates the need for a full-time employee in the operating room workflow.

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Simultaneous Bilateral Supine Anterior Approach Total Hip Arthroplasty: Evaluation of Early Complications and Short-Term Rehabilitation

Cited by 27 publications

References 21 publications

A Retrospective Analysis of the Merits and Challenges Associated with Simultaneous Bilateral THA using the Direct Anterior Approach

A Retrospective Analysis of the Merits and Challenges Associated with Simultaneous Bilateral THA using the Direct Anterior Approach

Skin Crease ‘Bikini’ Incision for Anterior Approach Total Hip Arthroplasty: Surgical Technique and Preliminary Results

Clinical and Radiographic Outcomes after Direct Anterior Approach Total Hip Arthroplasty Using Two Specialized Surgical Tables

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