Prospective, Randomized Study of Direct Anterior Approach vs Posterolateral Approach Total Hip Arthroplasty: A Concise 5-Year Follow-Up Evaluation

2019 ◽  
Vol 34 (6) ◽  
pp. 1139-1142 ◽  
Author(s):  
William P. Barrett ◽  
Shelly E. Turner ◽  
Jeffrey A. Murphy ◽  
Jana L. Flener ◽  
Timothy B. Alton
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Randomized Study ◽  
Direct Anterior Approach ◽  
Prospective Randomized Study ◽  
Posterolateral Approach ◽  
Total Hip

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 5-Year Clinical and Radiographic Results of the Direct Anterior Approach for Total Hip Arthroplasty Using a Collared Cementless Femoral Short-Stem Prosthesis

2022 ◽  
Vol 11 (2) ◽  
pp. 346
Author(s):  
Ali Darwich ◽  
Kim Pankert ◽  
Andreas Ottersbach ◽  
Marcel Betsch ◽  
Sascha Gravius ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Hip Osteoarthritis ◽  
Direct Anterior Approach ◽  
Short Stem ◽  
Total Hip ◽  
The Mean

The aim of this study was to investigate the radiological and clinical outcome of the direct anterior approach (DAA) in total hip arthroplasty (THA) using a collared cementless femoral short-stem. This retrospective study included 124 patients with 135 THAs operated from 2014 to 2016 using a collared cementless triple tapered hydroxyapatite-coated femoral short-stem (AMIStem H Collared®, Medacta International, Castel San Pietro, Switzerland) implanted with a DAA. Follow-up was performed at three months, 12 months, and five years. Clinical outcome was assessed using the hip osteoarthritis outcome score (HOOS) and radiological analysis was done using conventional radiographs, which included evaluation of the femur morphology based on Dorr classification, of radiolucencies based on the Gruen zone classification and of stem subsidence. The mean age was 67.7 ± 11.3 years and the mean body mass index (BMI) was 27.4 ± 4.4 kg/m2. The stem survival rate at five years was 99.1% with one revision due to recurrent dislocations. Mean HOOS score improved from 40.9 ± 18.3 preoperatively to 81.5 ± 19.7 at three months, 89.3 ± 10.9 at 12 months, and 89.0 ± 14.0 at five years (all with p < 0.001). No significant correlations were found between age, femoral bone morphology, BMI and HOOS, and the appearance of relevant radiolucencies.

A Prospective, Randomized Study of Cross-Linked and Non–Cross-Linked Polyethylene for Total Hip Arthroplasty at 10-Year Follow-Up

2012 ◽  
Vol 27 (8) ◽  
pp. 2-7.e1 ◽  
Author(s):  
Charles A. Engh ◽  
Robert H. Hopper ◽  
Cathy Huynh ◽  
Henry Ho ◽  
Supatra Sritulanondha ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Total Hip

scholarly journals Total Hip Arthroplasty Using Imageless Computer-Assisted Navigation—2-Year Follow-Up of a Prospective Randomized Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1620
Author(s):  
Richard Lass ◽  
Boris Olischar ◽  
Bernd Kubista ◽  
Thomas Waldhoer ◽  
Alexander Giurea ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Important Determinant ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Computer Assisted ◽  
Total Hip ◽  
Significant Difference

The purpose of this study is to compare computer-assisted to manual implantation-techniques in total hip arthroplasty (THA) and to find out if the computer-assisted surgery is able to improve the clinical and functional results and reduce the dislocation rate in short-terms after THA. We performed a concise minimum 2-year follow-up of the patient cohort of a prospective randomized study published in 2014 and evaluated if the higher implantation accuracy in the navigated group can be seen as an important determinant of success in total hip arthroplasty. Although a significant difference was found in mean postoperative acetabular component anteversion and in the outliers regarding inclination and anteversion (p < 0.05) between the computer-assisted and the manual-placed group, we could not find significant differences regarding clinical outcome or revision rates at 2-years follow-up. The implantation accuracy in the navigated group can be regarded as an important determinant of success in THA, although no significant differences in clinical outcome could be detected at short-term follow-up. Therefore, further long-term follow-up of our patient group is needed.

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

2020 ◽  
Vol 04 (01) ◽  
pp. 033-037
Author(s):  
Samantha Andrews ◽  
Gregory J. Harbison ◽  
Ian Hasegawa ◽  
Emily Unebasami ◽  
Cass Nakasone
Keyword(s):  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Femoral Stem ◽  
Direct Anterior Approach ◽  
Total Hip ◽  
Fracture Table ◽  
Short Femoral Stem

AbstractThe 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.

scholarly journals Bilateral simultaneous total hip arthroplasty: comparison of treatment outcome between the direct anterior approach and the posterolateral approach

2019 ◽  
Author(s):  
Shuo Feng ◽  
Ning Jian Sun ◽  
Yu Zhang ◽  
Ye Zhang ◽  
Yang Xiang Chen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Operation Time ◽  
Direct Anterior Approach ◽  
Posterolateral Approach ◽  
Joint Function ◽  
Total Hip ◽  
Postoperative Drainage

Abstract Background There are many surgical approaches for total hip arthroplasty. In recent years, direct anterior approach (DAA) has been highly praised by many scholars, and it has been widely reported that it has a good curative effect, such as fast recovery. Whether the surgical results and patient satisfaction can reach or exceed the traditional posterolateral approach has been controversial. We hypothesized that the treatment outcome of the direct anterior approach (DAA) approach is superior to the traditional posterolateral approach (PLA). Methods From January 2015 to April 2017, 20 patients (40 hips) were randomly divided into posterolateral approach (PLA) group and direct anterior approach (DAA) group. Record the operation time on both sides, postoperative drainage, prosthesis position, and complications, the functional recovery of hip joint was evaluated by D'Aubigne-Postel score, and the postoperative pain was evaluated by VAS score. Gait parameters were measured before surgery and at 3 and 6 months after surgery, and the patients were asked which side they preferred subjectively after surgery. Results When compared with the PLA group, the DAA group had a shorter incision length (11.4 vs 14.72 cm, P<0.001), shorter intraoperative blood loss (184.05vs 219.00 mL, P<0.001), shorter postoperative drainage volume (105.35 vs 154.10 mL, P<0.001), and lower VAS scores. However, the PLA had shorter operative times (82.20 vs 67.3 min, P<0.001). There was no significant difference in acetabular inclination (39.72 vs 40.92 °, P=0.069), and acetabular anteversion (17.41 vs 17.69°, P=0.663) between the two groups. Joint function recovery: The D'Aubigne-Postel scores of the hip joints in the DAA group vs PLA group at 1, 3, and 6 months after surgery were (8.2, 11.5, 16.5) vs (7.65, 11.45, 16.9). The difference in the 1, 3month was statistically significant (P=0.012, P=0.038), however, this difference disappeared in the 6th month(P=0.072). Conclusions Compared with the PLA, the DAA has the advantages of shorter operation time, smaller incision, less bleeding, less pain, better gait performance and faster recovery of joint function, but patients subjectively preferred the traditional PLA.

Are there more wound complications or infections with direct anterior approach total hip arthroplasty?

2018 ◽  
Vol 28 (6) ◽  
pp. 591-598 ◽  
Author(s):  
Christophe Tissot ◽  
Matthias Vautrin ◽  
Anais Luyet ◽  
Olivier Borens
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Wound Complication ◽  
Wound Complications ◽  
Obese Patients ◽  
Total Hip ◽  
Delayed Onset

Introduction: Compared to a lateral or posterior approach (PA), the direct anterior approach (DAA) does permit a better muscle preservation for total hip arthroplasty (THA). However, there is concern whether this advantage come with increased wound complication and infection leading to reoperation or sometimes major procedures. Method: We retrospectively reviewed all patients who underwent primary THA through the PA between January 2009 and April 2013 ( n = 796) and through the DAA between January 2011 and April 2013 ( n = 399) at our institution with a minimum of 2 years follow up regarding all wound complications and all infections. Results: Of the 796 patients in the PA group, there were 6 wound complications leading to reoperation and 6 infections; 4 early and 2 delayed onset. Among the infected cases, one was obese (body mass index [BMI] >30 kg/m2). Two procedures were teaching-based. Of the 399 patients in the DAA group, there were three dehiscences leading to reoperation, two of which were in obese patients. 6 infections were also found; 4 with early and 2 with delayed onset. Of the infected cases, three were obese. 4 procedures were teaching-based. Conclusion: In our series of patients undergoing THA, the DAA did not increase the rates of either wound complications leading to reoperation nor early or delayed infection compared to the PA.

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