Targeting the safe zones for cup position without fluoroscopic guidance in total hip arthroplasty: does the surgical approach affect the outcomes?

Trévisan, C.; Rocca, A.; Gallinari, Gianluca; Piscitello, Stefano; Klumpp, Raymond

doi:10.1007/s00590-021-02909-1

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…The extent to which the surgical approach effects the accuracy of cup positioning is under discussion. Some studies showed superior results for THA implanted via a direct anterior approach compared to posterior or lateral approaches and reported lower dislocation rates [ 22 , 23 , 24 , 25 ]. On the contrary, other authors reported comparable results, independent of the approach [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Achieving Precise Cup Positioning in Direct Anterior Total Hip Arthroplasty: A Narrative Review

Streck

Boettner

2023

Medicina

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Malpositioned implants in total hip arthroplasty are associated with impingement, increased wear, and dislocations, thus precise cup positioning is crucial. However, significant deviations between targeted and actually achieved cup positions have been found even in patients operated by experienced surgeons. When aiming for higher accuracy, various methods based on freehand positioning lead by anatomic landmarks, C-arm fluoroscopy, imageless navigation, or robotic-assisted-surgery have been described. There is a constant development of new products aiming to simplify and improve intraoperative guidance. Both the literature and expert opinions on this topic are often quite controversial. This article aims to give an overview of the different methods and systems with their specific advantages and potential pitfalls while also taking a look into the future of cup positioning in anterior hip replacements.

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Section: Introductionmentioning

confidence: 99%

Achieving Precise Cup Positioning in Direct Anterior Total Hip Arthroplasty: A Narrative Review

Streck

Boettner

2023

Medicina

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No benefit of direct anterior over posterolateral approach in total hip arthroplasty using dual-mobility acetabular component for femoral neck fracture

Peuchot,

Jacquet,

Fabre-Aubrespy

et al. 2024

Bone Joint J

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AimsDual-mobility acetabular components (DMCs) have improved total hip arthroplasty (THA) stability in femoral neck fractures (FNFs). In osteoarthritis, the direct anterior approach (DAA) has been promoted for improving early functional results compared with the posterolateral approach (PLA). The aim of this study was to compare these two approaches in FNF using DMC-THA.MethodsA prospective continuous cohort study was conducted on patients undergoing operation for FNF using DMC by DAA or PLA. Functional outcome was evaluated using the Harris Hip Score (HHS) and Parker score at three months and one year. Perioperative complications were recorded, and radiological component positioning evaluated.ResultsThere were 50 patients in the DAA group and 54 in the PLA group. The mean HHS was 85.5 (SD 8.8) for the DAA group and 81.8 (SD 11.9) for the PLA group (p = 0.064). In all, 35 patients in the DAA group and 40 in the PLA group returned to their pre-fracture Parker score (p = 0.641) in both groups. No statistically significant differences between groups were found at one year regarding these two scores (p = 0.062 and p = 0.723, respectively). The DAA was associated with more intraoperative complications (p = 0.013). There was one dislocation in each group, and four revisions for DAA and one for PLA, but this difference was not statistically significant. There were also no significant differences regarding blood loss, length of stay, or operating time.ConclusionIn DMC-THA for FNF, DAA did not achieve better functional results than PLA, either at three months or at one year. Moreover, DAA presented an increased risk of intra-operative complications.Cite this article: Bone Joint J 2024;106-B(5 Supple B):133–138.

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Targeting the safe zones for cup position without fluoroscopic guidance in total hip arthroplasty: does the surgical approach affect the outcomes?

Cited by 2 publications

References 32 publications

Achieving Precise Cup Positioning in Direct Anterior Total Hip Arthroplasty: A Narrative Review

Achieving Precise Cup Positioning in Direct Anterior Total Hip Arthroplasty: A Narrative Review

No benefit of direct anterior over posterolateral approach in total hip arthroplasty using dual-mobility acetabular component for femoral neck fracture

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