Use of traction table did not increase complications in total hip arthroplasty through direct anterior approach performed by novice surgeon

Abstract

Purpose: The purpose of this study was to investigate the surgical outcomes of total hip arthroplasty (THA) through direct anterior approach (DAA) performed by beginners by comparing the outcomes after the introduction of DAA-THA between using a normal operating table and a traction table. Methods: The total subjects were 200 patients, there were 120 cases from the introduction of three surgeons using a normal table and 80 cases from two surgeons using a traction table. The surgical procedure was standardized, and a surgeon skilled in DAA entered the operating room and instructed the novice surgeons of DAA in all cases. Results: The mean operative time was no significant difference between the two groups ( p = 0.093). The difference in slope of the operative time was no significant difference between the two groups ( p value = 0.089). The mean fluoroscopy time and the mean blood loss were significant difference between the two groups ( p < 0.05). The difference in slope of the fluoroscopy time and blood loss were significant difference between the two groups ( p < 0.05). There were no intraoperative complications and no reoperations for any reason. Conclusions: At the facility with a surgeon skilled in DAA, the use of a traction table in DAA did not increase the complication rate compared with the use of a normal operating table when the exclusion criteria for DAA were set and surgery was performed using intraoperative fluoroscopy under supervision by a skilled surgeon.

Hip arthroplasty for unstable femoral trochanteric fractures using the direct anterior approach

“…Using intraoperative uoroscopy, improper installation of the implant can be prevented [20]. A traction table has several advantages such as traction of the lower limb enabling acetabular operation, ease of retention of the limb position for femoral operation, and prevention of intraoperative fracture during reduction [21]. In addition, health damage due to the exposure time becomes problematic for both patients and operators as the number of patients increases [22].…”

Total hip arthroplasty with reconstruction of acetabulum through direct anterior approach for metastatic bone disease of acetabulum combined with pathological proximal femoral neck fracture: A case report

“…It was important for this elderly patient to achieve an early return to his activities of daily living; therefore, arthroplasty for the displaced femoral neck fracture through the DAA had advantages over other approaches. The DAA conserves soft tissue because it is an intermuscular approach [ 6 ]. Accordingly, postoperative recovery is fast and thus associated with a low dislocation rate and effective pain reduction, and a favorable postoperative outcome can be expected [ 6 ].…”

“…The DAA conserves soft tissue because it is an intermuscular approach [ 6 ]. Accordingly, postoperative recovery is fast and thus associated with a low dislocation rate and effective pain reduction, and a favorable postoperative outcome can be expected [ 6 ]. In addition, fluoroscopy can be easily used during surgery through the DAA because the patient is placed in the supine position [ 4 ].…”

Factors Influence on the Broaching Hammering Sound during Cementless Total Hip Arthroplasty

“…After reviewing the inclusion and J. Biomedical Science and Engineering exclusion criteria, 35 patients (average age: 66.0 ± 11.3 years) who received the Accolade II stem and 14 patients (average age: 72.4 ± 7.4 years) who received the Taperloc stem were included in this study (Table 1). These surgeries were performed by four experienced orthopedic surgeons via the direct anterior approach using the distal part of the Smith-Petersen approach with the patient in the supine position on a surgical traction table [17]. All surgeries were performed using the corresponding surgical instruments provided by the manufacturers except the surgical hammer, which we used a lightweight hammer (Stainless hammer 01-412-01 Large, Mizuho Medical, Tokyo, Japan) to achieve better control of the hammer blows.…”