Process optimized minimally invasive total hip replacement

The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

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Process-Optimized Minimally Invasive Total Hip Replacement via a Direct Anterior Approach with Navigation Control of Leg Length and Offset

Computer and Template Assisted Orthopedic Surgery ◽

10.1007/978-3-642-29728-1_16 ◽

2013 ◽

pp. 137-143

Author(s):

Philipp Gebel ◽

Markus Oszwald ◽

Bernd Ishaque ◽

Gaffar Ahmed ◽

Recha Blessing ◽

...

Keyword(s):

Minimally Invasive ◽

Total Hip Replacement ◽

Hip Replacement ◽

Anterior Approach ◽

Direct Anterior Approach ◽

Leg Length ◽

Total Hip ◽

Navigation Control

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The minimally invasive total hip replacement via the direct anterior approach: A short term clinical and radiological results

Alexandria Journal of Medicine ◽

10.1016/j.ajme.2013.09.004 ◽

2014 ◽

Vol 50 (1) ◽

pp. 31-36 ◽

Cited By ~ 1

Author(s):

Helmy Fekry Refai ◽

Mohamed Samir Kassem

Keyword(s):

Minimally Invasive ◽

Total Hip Replacement ◽

Hip Replacement ◽

Anterior Approach ◽

Direct Anterior Approach ◽

Short Term ◽

Total Hip ◽

Radiological Results ◽

Clinical And Radiological Results

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Simultaneous Bilateral Minimally Invasive Direct Anterior Approach Total Hip Arthroplasty with fast track Protocol

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0013.9780 ◽

2020 ◽

Vol 22 (1) ◽

pp. 17-25

Author(s):

Lukasz Kolodziej ◽

Andrzej Bohatyrewicz ◽

Alina Jurewicz ◽

Karina Szczypiór-Piasecka ◽

Krzysztof Przybył

Keyword(s):

Surgical Treatment ◽

Blood Transfusion ◽

Minimally Invasive ◽

Hip Replacement ◽

Anterior Approach ◽

Fast Track ◽

Perioperative Management ◽

Direct Anterior Approach ◽

Total Hip ◽

The Mean

Background. Advanced degenerative hip joint disease is bilateral in approximately 20% of cases, prompting questions of whether it is necessary to perform two separate surgical procedures, whether simultaneous bilateral hip replacement makes the surgical treatment too extensive, and whether it significantly affects the postoperative course. Material and methods. The study analysed the duration of hospitalisation, perioperative complications, and the need for blood transfusion in 30 patients (27 men and 3 women) with bilateral hip osteoarthritis who underwent simultaneous bilateral total hip replacement from a minimally invasive direct anterior approach followed by a fast track protocol for optimisation of perioperative management between 2014 and 2017. The mean age of patients was 60.2 years (range 43 to 77 years) and the mean follow-up period was 28 months (range 18 to 48 months). Results. Mean duration of hospitalisation was 4.5 days (range 3 to 9 days). A total of 4 patients (13%) required allogeneic blood transfusion. No patient developed thromboembolic or infectious complications or implant dislocation after surgery. Apart from one case where the acetabulum was not selected correctly, which resulted in postoperative loosening, there were no other significant medical events potentially related to the surgical treatment. Conclusions. Simultaneous bilateral total hip arthroplasty using a minimally invasive direct approach and a fast track protocol for optimisation of perioperative management does not increase the need for perioperative blood transfusion or the number of surgical complications and constitutes a safe, effective, and recommendable method of treatment in patients with advanced bilateral degenerative disease of the hip joints.

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Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

Journal of International Medical Research ◽

10.1177/03000605211012210 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110122

Author(s):

Wenlu Liu ◽

Huanyi Lin ◽

Xianshang Zeng ◽

Meiji Chen ◽

Weiwei Tang ◽

...

Keyword(s):

Femoral Neck ◽

Clinical Outcomes ◽

Total Hip Replacement ◽

Hip Replacement ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Complication Rates ◽

Total Hip ◽

Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

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