The Direct Anterior Approach is Associated With Early Revision Total Hip Arthroplasty

Eto, Sumiya; Hwang, Katherine; Huddleston, James I.; Amanatullah, Derek F.; Maloney, William J.; Goodman, Stuart B.

doi:10.1016/j.arth.2016.09.012

Cited by 82 publications

(52 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Proponents of the AA report advantages of shorter hospital stay, less perioperative pain, faster functional recovery, and lower dislocation risk [4e6]. Others have reported a protracted learning curve and higher early revision rates with AA [7,8]. Candidates for THA report that their choice of surgical approach is based, in part, on their desire for a technique that allows quicker functional recovery [9].…”

mentioning

confidence: 99%

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Miller

Gondusky

Bhattacharyya³

et al. 2018

The Journal of Arthroplasty

142

View full text Add to dashboard Cite

In this systematic review and meta-analysis of prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA, patients treated with AA reported less pain, consumed fewer narcotics, and reported better hip function. No statistical differences in complication rates were detected between AA and PA. Ultimately, the choice of surgical approach in primary THA should consider preference and experience of the surgeon as well as preference and anatomy of the patient.

show abstract

mentioning

confidence: 99%

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Miller

Gondusky

Bhattacharyya³

et al. 2018

The Journal of Arthroplasty

142

View full text Add to dashboard Cite

show abstract

“…Following the perioperative period, mechanical loosening has been shown to occur more frequently in DAA THA than in other approaches. 19,[24][25][26][27] However, previous research has also reported a 2-year implant survival rate of 99.1% following DAA THA and 98.2 to 100% when using a short femoral stem. 3,26 Although similar, the reported 2-year survival rate of 98.7% when using the short, tapered wedge stem is still lower than the 100% 2-year survival rate previously reported for the collared femoral stem design.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Fracture Risk and Two-Year Survivorship of a Short Tapered Femoral Stem following Direct Anterior Approach Cementless Total Hip Arthroplasty with a Fracture Table

et al. 2020

View full text Add to dashboard Cite

The cementless, tapered wedge, short femoral stem implant is commonly used in direct anterior approach (DAA) total hip arthroplasty (THA). The lack of access and visualization, however, may increase the risk of perioperative fracture and early failure. Therefore, the current study examined perioperative complications and 2-year implant survivorship following DAA THA performed using a fracture table and short, tapered wedge femoral stem. A retrospective analysis was conducted on patients having undergone DAA THA with a cementless, tapered wedge, short femoral stem. Perioperative fractures were noted and survivorship was determined by the incidence of revision surgery within a minimum 2-year follow-up period. A total 366 consecutive patients (441 hips) were identified in the cohort. Four patients (6 hips; 1.4%) were lost to follow-up and three patients died from unrelated causes. Average follow-up time for the remaining 359 patients (435 hips) was 32.9 ± 10.2 months. There were no intraoperative factures but three perioperative fractures within two weeks. Aseptic loosening occurred in one stem at 13 months, resulting in a 99.1% survival rate with a mean survival time of 23.8 ± 0.1 months (95% confidence interval: 23.6–24.0 months). The use of a short, tapered wedge femoral stem and a fracture table for DAA THA resulted in 0.7% periprosthetic fractures and only one aseptic loosening within 2 years. These results suggest that proper femoral exposure with the use of a fracture table and a short, tapered wedge femoral stem does not appear to increase the risk of periprosthetic femoral fracture.

show abstract

“…Potential drawbacks of DAA THA include risk of nerve dysfunction, intraoperative femoral fracture, wound complications, early femoral failure, and dislocation. Such complications may be avoided by experienced DAA operators; however, the DAA learning curve is steep.…”

Section: Direct Anterior Approach Total Hip Arthroplastymentioning

confidence: 99%

Total Hip Arthroplasty for Crowe Type IV Hip Dysplasia: Surgical Techniques and Postoperative Complications

Shi

Han

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

Total hip arthroplasty (THA) of Crowe type IV developmental dysplasia of the hip (DDH) is challenging. Although traditional (lateral, posterolateral, and posterior) THA approaches have been used with great anatomic success, they damage periarticular muscles, which are already quite weak in type IV DDH. The recently developed direct anterior approach (DAA) can provide an inter‐nerve and inter‐muscle approach for THA of type IV dysplasia hips. However, femur exposure with the DAA could be difficult during surgery and it is hard to apply femoral shortening osteotomy. THA techniques used for type IV DDH include anatomic hip center techniques (true acetabular reconstruction) and high hip center techniques, wherein an acetabulum is reconstructed above the original one. Although anatomic construction of the hip center is considered “the gold standard” treatment, it is impossible if the anatomical acetabular is too small and shallow. Procedures used to support type IV DDH reduction with anatomic hip center techniques include greater trochanter osteotomy, lesser trochanter osteotomy, and subtrochanteric osteotomy. However, these techniques have yet to be standardized, and it is unclear which is best for type IV DDH. One‐state and two‐state non‐osteotomy reduction techniques have also been introduced to treat type IV DDH. Potential complications of THA performed in patients with type IV DDH include leg length discrepancy (LLD), peri‐operative femur fracture, nonunion of the osteotomy site, and nerve injury. It is worth noting that nowadays an increasing number of Crowe type IV DDH patients are more sensitive to postoperative LLD.

show abstract

The Direct Anterior Approach is Associated With Early Revision Total Hip Arthroplasty

Cited by 82 publications

References 28 publications

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis

Perioperative Fracture Risk and Two-Year Survivorship of a Short Tapered Femoral Stem following Direct Anterior Approach Cementless Total Hip Arthroplasty with a Fracture Table

Total Hip Arthroplasty for Crowe Type IV Hip Dysplasia: Surgical Techniques and Postoperative Complications

Contact Info

Product

Resources

About