The Learning Curve of the Direct Anterior Approach without Traction Table in Total Hip Replacement: Using the LC-CUSUM Method

Steentjes, Koen; Beekhuizen, Stefan; Eilander, Wouter; Meesters, Wendy; Kampen, Paulien M. van; Lugt, J. C. T. van der

doi:10.1055/s-0039-1678740

Cited by 1 publication

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,7,9,51,[57][58][59] A total of 9 standard table studies (n = 3199) reported a mean length of stay of 3.8 ± 2.3 days. 27,31,33,34,39,43,45,48,49 Notably, Vayalapra et al 47 found a significant decline in length of stay with increasing surgeon experience (r = -0.296, p = 0.014). Length of stay was reported by 8 traction table studies (n = 3056) with a mean length of stay of 3.0 ± 1.9 days.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

“…7,9,11,50,52,55,56,60,63 Quality assessment MINORS scores indicated fair quality with a mean score for standard Mean body mass index (BMI) was reported in 9 standard table studies with a mean BMI of 29.5 ± 7.3 kg/m 2 (n = 3,487). 14,27,29,34,36,41,[43][44][45] In 14 traction table studies, mean BMI was 27.7 ± 6.0 kg/m 2 (n = 8,680) ( Table 3).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In standard table studies, intraoperative fluoroscopy was used in 93.6% (3288/3512) of patients in the 7 studies (n = 3512) that reported its use. 14,33,37,40,44,45,48 In comparison, intraoperative fluoroscopy was used in 96.9% (10,870/11,220) of patients in the 16 traction table studies that reported it. 5,7,9,11,[50][51][52][55][56][57][58][59][60][61][62][63] In 15 standard table studies reporting specific implants (n = 4130), there were 54 (1.3%) cemented femoral implants used 26,42 and 4076 (98.7%) cementless femoral implants used.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…5,7,9,11,[50][51][52][55][56][57][58][59][60][61][62][63] In 15 standard table studies reporting specific implants (n = 4130), there were 54 (1.3%) cemented femoral implants used 26,42 and 4076 (98.7%) cementless femoral implants used. 14,26,29,33,[36][37][38][39][40][41][42][43][44][45]48 In 11 traction table studies that reported specific implants (n = 7189), there were 76 (1.0%) cemented femoral implants 9,54,59 and 7351 (99.0%) cementless femoral implants used. 7,9,11,50,52,55,56,60,63 Quality assessment MINORS scores indicated fair quality with a mean score for standard Mean body mass index (BMI) was reported in 9 standard table studies with a mean BMI of 29.5 ± 7.3 kg/m 2 (n = 3,487).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…There were 14 standard table studies reporting a mean operative time of 70.9 ± 21.2 mins (n = 4402). 27,29,31,33,35,[36][37][38][39]44,45,[47][48][49] Mean operative time across 10 traction table studies was 100.1 ± 32.6 mins (n = 3518). 5,9,[50][51][52]54,58,61,63 A total of 8 standard table studies (n = 2992) reported estimated blood loss (EBL) as an outcome with a mean EBL of 382.3 ± 246.4 mL.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

See 4 more Smart Citations

Traction table versus standard table total hip arthroplasty through the direct anterior approach: a systematic review

et al. 2020

View full text Add to dashboard Cite

Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) was originally performed with a supine patient on a specialised traction table, but the approach can also be performed on a standard operating table. Despite cost and safety implications, there are few studies directly comparing these techniques and table choice remains largely surgeon preference. The purpose of this review was to compare the clinical outcomes and complication profiles of traction and standard table DAA for primary THA. Methods: The authors searched databases for relevant studies, screening in duplicate. Study quality was assessed using MINORS criteria or Cochrane Risk of Bias Tool. Data pertaining to patient demographics, clinical outcomes, and complications were abstracted. Results: Of 3085 initial titles, 44 studies containing a total 26,353 patients were included and analysed. Mean operative time was 70.9 ± 21.2 minutes for standard table ( n = 4402) and 100.1 ± 32.6 minutes for traction table ( n = 3518). Mean estimated blood loss was 382.3 ± 246.4 mL for standard ( n = 2992) and 531.7 ± 364.3 mL for traction table ( n = 2675). Intra-operative fracture rate was 1.3% for standard table ( n = 3940) and 1.7% for traction table ( n = 8386). Complication rates including revisions, dislocations and peri-prosthetic fractures were qualitatively similar between traction and standard table studies. Conclusion: Standard table and traction table DAA have similar outcomes and complications. Both techniques offer the short-term advantages of DAA when compared to other THA approaches. However, the standard table technique may offer perioperative advantages including decreased blood loss, shorter operative time, and fewer intraoperative fractures. In the context of rising global healthcare costs and lack of access to specialised orthopaedic traction tables, this review at minimum confirms the short-term safety of standard table DAA THA and prompts the need for future studies to directly compare these techniques.

show abstract