scholarly journals Comparison of the Early Results of Lateral Direct Anterior Approach (L-DAA) and Traditional Posterolateral Approach (PLA) in Hip Arthroplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lin Wang ◽  
Zhujun Xu
Keyword(s):  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Analogue Scale ◽  
Direct Anterior Approach ◽  
Posterolateral Approach ◽  
Acetabular Anteversion ◽  
Early Recovery ◽  
Pain Scores ◽  
Early Results

Objective. To evaluate the early results of lateral direct anterior approach (L-DAA) and traditional posterolateral approach (PLA) in hip arthroplasty. Methods. A total of 24 patients who underwent hip replacement from 2018 to 2021 were divided into PLA group ( N = 12 ) and L-DAA group ( N = 12 ) according to the method of random table number. Outcomes were evaluated between the two groups. Results. The length of incision was shorter; the amount of bleeding was less in the L-DAA group than that in the PLA group. The visual analogue scale (Vas) pain scores for the L-DAA group were significantly lower than that for the PLA group at 24 h, 72 h, and 1 month after operation, and Harris hip scores in the L-DAA group were significantly high in the PLA group at 1 month after operation. In addition, there are no statistically significant differences in acetabular anteversion, abduction, and angle between the two groups. Conclusion. L-DAA was superior to PLA for early recovery after hip arthroplasty.

Transitioning to the direct anterior approach in total hip arthroplasty. Is it a true muscle sparing approach when performed by a low volume hip replacement surgeon?

2017 ◽  
Vol 41 (11) ◽  
pp. 2245-2252 ◽  
Author(s):  
Dan-Viorel Nistor ◽  
Sergiu Caterev ◽  
Sorana-Daniela Bolboacă ◽  
Dan Cosma ◽  
Dan Osvald Gheorghe Lucaciu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Total Hip ◽  
Muscle Sparing ◽  
Low Volume

scholarly journals Fully hydroxyapatite-coated collared femoral stems in direct anterior versus direct lateral hip arthroplastyFully hydroxyapatite-coated collared femoral stems in direct anterior versus direct lateral hip arthroplasty

2021 ◽  
Vol 64 (2) ◽  
pp. E205-E210
Author(s):  
Sebastian Heaven ◽  
Maxwell Perelgut ◽  
Edward Vasarhelyi ◽  
James Howard ◽  
Matthew Teeter ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Approach ◽  
Early Recovery ◽  
Total Hip ◽  
Significant Difference ◽  
Femoral Stems ◽  
Direct Lateral Approach

Background: Total hip arthroplasty (THA) via the direct anterior approach has increased in popularity in the last decade, with research supporting enhanced early recovery; however, some investigators have reported increased early revision rates in direct anterior THA. We examined outcomes from a single institution’s experience with a fully hydroxyapatite-coated collared femoral stem implanted via the anterior or the lateral approach. Methods: Patients who had received fully hydroxyapatite-coated collared femoral stems as part of THA surgery performed by 1 of 3 surgeons between January 2012 and September 2017 were identified from our institutional database. We examined revision rates for the 2 approaches and compared them between the 2 groups. We also analyzed outcomes on plain film radiographs obtained immediately postoperatively and at 1 and 2 years. Results: A total of 695 patients received a fully hydroxyapatite-coated collared stem during the study period. Total hip arthroplasty was performed via the direct anterior approach in 281/778 hips (36.1%) and via the direct lateral approach in 497 (63.9%). Nineteen patients (2.5%) underwent subsequent revision surgery; there was no statistically significant difference in the revision rate between the anterior and lateral approaches (2.5% v. 2.4%, p = 0.95). The mean subsidence of the stem at 1 year was 1.68 mm (standard deviation 11.7 mm). No statistically significant differences were observed between the cohorts for any of the radiographic measurements at either follow-up time. Conclusion: We found no significant difference in revision rates between the direct anterior and direct lateral approach. Stem subsidence levels were in keeping with expected values, and no major changes in stem position occurred during the first postoperative year. Surgical approach did not appear to substantially affect biomechanical stem behaviour.

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.

Difference in Stem Alignment Between the Direct Anterior Approach and the Posterolateral Approach in Total Hip Arthroplasty

2015 ◽  
Vol 30 (10) ◽  
pp. 1761-1766 ◽  
Author(s):  
Hirohito Abe ◽  
Takashi Sakai ◽  
Masaki Takao ◽  
Takashi Nishii ◽  
Nobuo Nakamura ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Posterolateral Approach ◽  
Total Hip

scholarly journals Clinical evaluation of direct anterior approach total hip arthroplasty for severe developmental dysplasia of the hip

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zaiyang Liu ◽  
Courtney D. Bell ◽  
Alvin C. Ong ◽  
Jun Zhang ◽  
Jie Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Result ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Developmental Dysplasia ◽  
Posterolateral Approach ◽  
Hip Abductor ◽  
Dysplasia Of The Hip ◽  
Flexor Strength

AbstractIt is challenging to treat developmental dysplasia of the hip (DDH) classified Crowe III-IV using direct anterior approach (DAA) total hip arthroplasty (THA), and very little is known on its outcome. This study aimed to investigate the clinical result in this defined disorder with DAA versus posterolateral approach. Twenty-three consecutive hips with Crowe III-IV DDH who underwent DAA were retrospectively evaluated from 2016 through 2018. Outcomes were primarily assessed by HHS, WOMAC, and SF-12 physical scales. The second evaluations included leg length discrepancy, hip muscle strength, radiographic review, complications, and limp recovery. Results were compared to a control cohort of 50 hips underwent posterolateral THA concurrently within the observational period. At last follow-up (DAA 28.5 months; PLA 39.0 months), the mean increase of the HHS for DAA was 48.2 and 30.3 for PLA (p = 0.003). The improvement in WOMAC score in DAA cohort was 15.89 higher that of the PLA cohort after adjusting preoperative difference [R2 = 0.532, P = 0.000, 95% CI (10.037, 21.735)]. DAA had more rapid recovery of hip abductor strength at 1-month (p = 0.03) and hip flexor strength at 3 months (p = 0.007) compared to PLA. No significant differences were found in the radiographic analysis with the exception of increased acetabular anteversion in the DAA cohort (p = 0.036). Satisfactory improvement in limp, indicated by the percentage of limp graded as none and mild to the total, was much higher in DAA cohort (97.6%), compared to that of PLA cohort (90.0%, p = 0.032). DAA for high-dislocated dysplasia demonstrate a significant improvement in clinical result comparable to posterolateral approach. Improved clinical outcome in terms of increased HHS and WOMAC scores, rapid recovery of hip abductor and flexor strength, and enhanced limp recovery without an increased risk in complications, could be acquired when the surgeons were specialized in this approach.

scholarly journals Clinical Evaluation of Direct Anterior Approach Total Hip Arthroplasty for Crowe Type III-IV Developmental Dysplasia of the Hip with Matched Comparison to Posterolateral Approach

2021 ◽  
Author(s):  
Zaiyang Liu ◽  
Courtney Bell ◽  
Alvin Ong ◽  
Jun Zhang ◽  
Jie Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Result ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Developmental Dysplasia ◽  
Posterolateral Approach ◽  
Hip Abductor ◽  
Dysplasia Of The Hip ◽  
Flexor Strength

Abstract Aims It is challenging to treat developmental dysplasia of the hip (DDH) classified Crowe III-IV using direct anterior approach (DAA) total hip arthroplasty (THA), and very little is known on its outcome. This study aimed to investigate the clinical result in this defined disorder with DAA versus posterolateral approach.Methods Twenty-three consecutive hips with Crowe III-IV DDH who underwent DAA were retrospectively evaluated from 2016 through 2018. Outcomes were primarily assessed by HHS, WOMAC, and SF-12 physical scales. The second evaluations included leg length discrepancy, hip muscle strength, radiographic review, complications, and limp recovery. Results were compared to a control cohort of 50 hips underwent posterolateral THA concurrently within the observational period.Results At last follow-up (DAA 28.5 months; PLA 39.0 months), the mean increase of the HHS for DAA was 48.2 and 30.3 for PLA (p = 0.003). The improvement in WOMAC score in DAA cohort was 15.89 higher that of the PLA cohort after adjusting preoperative difference [R2 = 0.532, P = 0.000, 95%CI (10.037, 21.735)]. DAA had more rapid recovery of hip abductor strength at 1-month (p = 0.03) and hip flexor strength at 3 months (p = 0.007) compared to PLA. No significant differences were found in the radiographic analysis with the exception of increased acetabular anteversion in the DAA cohort (p = 0.036). Satisfactory improvement in limp, indicated by the percentage of limp graded as none and mild to the total, was much higher in DAA cohort (97.6%), compared to that of PLA cohort (90.0%, p = 0.032).Conclusions DAA for high-dislocated dysplasia demonstrate a significant improvement in clinical result comparable to posterolateral approach. Improved clinical outcome in terms of increased HHS and WOMAC scores, rapid recovery of hip abductor and flexor strength, and enhanced limp recovery without an increased risk in complications, could be acquired when the surgeons were specialized in this approach.

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