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

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.

scholarly journals Process optimized minimally invasive total hip replacement

2012 ◽  
Vol 3 (2) ◽  
pp. 3 ◽  
Author(s):  
Philipp Gebel ◽  
Markus Oszwald ◽  
Bernd Ishaque ◽  
Gaffar Ahmed ◽  
Recha Blessing ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Direct Anterior Approach ◽  
Operation Technique ◽  
Complication Rates ◽  
Leg Length ◽  
Total Hip ◽  
The Mean ◽  
Mean Time

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.

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.

Systematic Review of Radiological Analysis of Total Hip Replacement via Direct Anterior Approach in Comparison to Other Approaches – Study Protocol

2020 ◽  
Author(s):  
Bartosz Maciąg ◽  
Kuba Radzimowski ◽  
Piotr Stępiński ◽  
Jakub Szymczak ◽  
Tomasz Albrewczyński ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Femoral Stem ◽  
Direct Anterior Approach ◽  
Controlled Trials ◽  
Total Hip ◽  
Randomized Controlled ◽  
Radiological Analysis

Abstract Background Total hip arthroplasty (THR) is considered as the most effective available method of treatment of end-stage hip osteoarthritis (OA). This surgery can be performed via many different approaches. One of the newly developed technique is called direct anterior approach (DAA). It gains popularity and recognition as the least traumatic to the soft tissues, thus quickening rehabilitation and improving joint stability in the early postoperative period. There are no systematic reviews covering this subject in terms of potential differences in radiological prosthesis placement, and while there is still unsatisfactory evidence concerning long-term outcomes of DAA, such review may prove useful in the debate. The objective of our study was to systematically collect and review available data from randomized-controlled trials (RCTs) regarding radiographic assessment of prosthesis placement after total hip arthroplasty using direct anterior approach compared to other common approaches.Methods A systematic review of randomized controlled trials (RCTs) will be conducted. SciFinder, Scopus, ScienceDirect, PubMed, Embase, Clinical Key and The Cochrane Library databases will be searched without restriction to date up to June 2020. Primary outcomes will include measurements related with the radiological analysis of trials comparing use of DAA to other approaches used for THR, containing at least two of the following: femoral stem alignment, mean radiographic cup inclination, mean radiographic cup anteversion, mean radiographic cup abduction, position in Lewinnek's safe zone. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Cochrane Risk-of-Bias Tool for RCTs. Discussion This systematic review will provide missing information regarding influence of differences between DAA and other surgical approaches in total hip replacement on prosthesis implants placement in case of femoral stem and cup. This may result in improving knowledge and awareness of surgeons, improving patients satisfaction and functional outcome and lowering the risk of hip dislocations and other complications. Trial registration International Registration of Systematic reviews (PROSPERO) number CRD42019122675

scholarly journals The Influence of Body Mass Index and Hip Anatomy on Direct Anterior Approach Total Hip Replacement

2016 ◽  
Vol 25 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Weilin Sang ◽  
Libo Zhu ◽  
Jinzhong Ma ◽  
Haiming Lu ◽  
Cong Wang
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Total Hip ◽  
Hip Anatomy

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
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