Surgical technique of direct anterior approach for total hip arthroplasty on a standard operating room table

2018 ◽  
Vol 3 ◽  
pp. 34-34 ◽  
Author(s):  
David C. Holst ◽  
Marc R. Angerame ◽  
Charlie C. Yang
Keyword(s):  
Surgical Technique ◽  
Total Hip Arthroplasty ◽  
Operating Room ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Total Hip ◽  
Operating Room Table ◽  
Standard Operating

scholarly journals The bikini incision anterior cemented total hip arthroplasty: Assessment of radiological and clinical outcomes

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 3
Author(s):  
Ikram Nizam ◽  
Avinash Alva ◽  
Sophia Gogos
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Operating Table ◽  
Total Hip ◽  
Femoral Stems ◽  
Standard Operating

Introduction: There has been an increased interest in minimally invasive direct anterior approach total hip arthroplasty (THA) to provide greater patient satisfaction, improve pain relief, and reduce the duration of hospitalisation. A direct anterior approach hybrid cemented THA, utilising a bikini line incision, can be technically challenging. We aimed to undertake radiological analysis of femoral stem cementation, clinical outcomes, and component survivorship. Methods: Over a 5-year period, 215 primary elective bikini anterior THA conducted by a single surgeon were included. All procedures were performed using a cemented collarless polished stem. The operation was performed on a standard operating table. Patients undergoing posterior approach, revision procedures, and fractured neck of femurs were excluded. Post-operative radiographs were analysed for femoral cementation quality using the Barrack grading system. Harris hip scores (HHS) were determined at 6 weeks, 12 weeks, annually thereafter and the difference in HHS was noted. Results: In total, 215 anterior bikini THA (R = 101, L = 114) were performed in 199 patients (M = 89, F = 110) with a mean age of 77 and mean follow up of 2.9 years (range = 0.5–5). Radiographic analysis of femoral cementation showed 189 femoral stems (88%) were either Barrack A or B cementation grade, suggesting optimal cementation. Lucency in the cement-bone interface occurred mainly in Gruen Zone 1 (43%) and Zone 13(46.9%). At the most recent follow-up (mean 2.9 years), component survivorship was at 99.54% (stem). Significant improvement was noted in Harris hip scores at final follow-up (from 54 preoperatively to 92.7 at 2.9 years postoperatively). Conclusion: Our results suggest that a bikini incision direct anterior approach for total hip arthroplasty can be safely employed to perform cemented femoral stems on a standard operating table.

scholarly journals Repair of Symptomatic Partial Gluteus Medius Tear During Total Hip Arthroplasty Through the Direct Anterior Approach

2021 ◽  
Vol 10 (2) ◽  
pp. e575-e580
Author(s):  
David R. Maldonado ◽  
Samantha C. Diulus ◽  
Mitchell B. Meghpara ◽  
Rachel M. Glein ◽  
Hari K. Ankem ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Gluteus Medius ◽  
Direct Anterior Approach ◽  
Total Hip

scholarly journals Promising medium-term results of anterior approach with an anatomical short stem in primary hip arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fabrizio Rivera ◽  
Alessandro Bardelli ◽  
Andrea Giolitti
Keyword(s):  
Operating Room ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Short Stem ◽  
Medium Term ◽  
Operating Room Table ◽  
Sf 36 ◽  
Standard Operating ◽  
The Mean

Abstract Background In the last decade, the increase in the use of the direct anterior approach to the hip has contributed to the diffusion of the use of short stems in orthopedic surgery. The aim of the study is to verify the medium-term clinical and radiographic results of a cementless anatomic short stem in the anterior approach to the hip. We also want to verify whether the use of the standard operating room table or the leg positioner can affect the incidence of pre- and postoperative complications. Materials and methods All total hip arthroplasty patients with a 1-year minimum follow-up who were operated using the MiniMAX stem between January 2010 and December 2019 were included in this study. Clinical evaluation included the Harris Hip Score (HHS), Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC) Score, and Short Form-36 (SF-36) questionnaires. Bone resorption and remodeling, radiolucency, osteolysis, and cortical hypertrophy were analyzed in the postoperative radiograph and were related to the final follow-up radiographic results. Complications due to the use of the standard operating room table or the leg positioner were evaluated. Results A total of 227 patients (238 hips) were included in the study. Average age at time of surgery was 62 years (range 38–77 years). Mean follow-up time was 67.7 months (range 12–120 months). Kaplan–Meier survivorship analysis after 10 years revealed 98.2% survival rate with revision for loosening as endpoint. The mean preoperative and postoperative HHS were 38.35 and 94.2, respectively. The mean preoperative and postoperative WOMAC Scores were 82.4 and 16.8, respectively. SF-36 physical and mental scores averaged 36.8 and 42.4, respectively, before surgery and 72.4 and 76.2, respectively, at final follow-up. The radiographic change around the stem showed bone hypertrophy in 55 cases (23%) at zone 3. In total, 183 surgeries were performed via the direct anterior approach (DAA) on a standard operating room table, and 44 surgeries were performed on the AMIS mobile leg positioner. Comparison between the two patient groups did not reveal significant differences. Conclusion In conclusion, a short, anatomic, cementless femoral stem provided stable metaphyseal fixation in younger patients. Our clinical and radiographic results support the use of this short stem in the direct anterior approach. Level of evidence IV.

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