Transitioning the total hip arthroplasty technique from posterior approach in lateral position to direct anterior approach in supine position—risk factors for acetabular malpositioning and the learning curve

2020 ◽  
Vol 44 (9) ◽  
pp. 1669-1676 ◽  
Author(s):  
Constant Foissey ◽  
Cécile Batailler ◽  
Cam Fary ◽  
Francesco Luceri ◽  
Elvire Servien ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Position ◽  
Total Hip

scholarly journals Direct Anterior Approach for Total Hip Arthroplasty in the Lateral Decubitus Position Versus Supine Position: A Random Clinical Trial

2021 ◽  
Author(s):  
Yao Xiao ◽  
Zhanglai Li ◽  
Feitai Lin ◽  
Yiyuan Zhang ◽  
Yan Weng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Position ◽  
Lateral Decubitus Position ◽  
Population Characteristics ◽  
Total Hip ◽  
Lateral Decubitus

Abstract Background: Direct anterior approach (DAA）for total hip arthroplasty (THA）could be performed either in the lateral decubitus position or supine position. However, there is an obvious absence of literature regarding the differences, which position may be more conducive to recovery, technically more demanding, associated with component malposition or more complications. Methods: From Jan.1st, 2020 to oct.1st, 2020, 45 patients were recruited for primary unilateral THA using the DAA. In total, 27 patients (60%) underwent THAs using the DAA in the supine position, and 18 patients (40%) in the lateral decubitus position. All surgeries were performed by a high-volume surgeon. Technical information, clinical and radiographic outcomes, SF-12 and patient-reported outcomes such as WOMAC were evaluated. All the date were tested with Generalized Linear Mixed Models Analysis, GLM Repeated Measurement Analysis, Independent samples t-test or Pearson’s chi-square test.Results: There were no differences in Population characteristics before surgery. The operation time, length of stay and blood loss in the LP group and the SP group were no differences. The prosthesis of the two groups were in a good position. pre-operative and the first and third day after the surgery of CK-MB and Hb,pre-operative and the last follow-up of HSS,WOMAC,UCLA,VAS,SF-12,and pre-operation and post-operation of Offset,FA and LLD, all the above indicators show no significant difference. And the incidence of complications in the lateral position was lower than that in the supine position.Conclusion: Both THA via DAA in the lateral decubitus position and in the supine position produced excellent clinical outcomes. From the perspective of the occurrence of complications, we are more inclined to use the lateral position.

scholarly journals Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

2015 ◽  
Vol 9 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Motohiro Wakui
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Dislocation Rate ◽  
Rank Test ◽  
Consecutive Series ◽  
Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

scholarly journals Total hip arthroplasty performed by direct anterior approach – Does experience influence the learning curve?

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 15 ◽  
Author(s):  
Constant Foissey ◽  
Mathieu Fauvernier ◽  
Cam Fary ◽  
Elvire Servien ◽  
Sébastien Lustig ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Operating Time ◽  
Surgical Techniques ◽  
Direct Anterior Approach ◽  
Clinical Results ◽  
Total Hip ◽  
Significant Difference

Introduction: Proficiency in the direct anterior approach (DAA) as with many surgical techniques is considered to be challenging. Added to this is the controversy of the benefits of DAA compared to other total hip arthroplasty (THA) approaches. Our study aims to assess the influence of experience on learning curve and clinical results when transitioning from THA via posterior approach in a lateral position to DAA in a supine position. Methods: A consecutive retrospective series of 525 total hip arthroplasty of one senior and six junior surgeons was retrospectively analysed from May 2013 to December 2017. Clinical results were analysed and compared between the two groups and represented as a learning curve. Mean follow up was 36.2 months ± 11.8. Results: This study found a significant difference in complications between the senior and junior surgeons for operating time, infection rate, and lateral femoral cutaneous nerve (LFCN) neuropraxia. A trainee’s learning curve was an average of 10 DAA procedures before matching the senior surgeon. Of note, the early complications correlated with intraoperative fractures increased with experience in both groups. Operating time for the senior equalised after 70 cases. Dislocation rate and limb length discrepancy were excellent and did not show a learning curve between the two groups. Conclusion: DAA is a safe approach to implant a THA. There is a learning curve and initial supervision is recommended for both seniors and trainees. Level of evidence: Retrospective, consecutive case series; level IV.

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