ALMIS Anterolateral Hip Approach Using a Different Table and Legs Position during Femoral Exposure; New Surgical Technique

Christodoulou, Nikolaos

doi:10.15406/mojor.2017.07.00282

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…All patients, under subarachnoid anesthesia, underwent THA with the modified anterolateral minimal invasive approach (ALMIS) in the lateral position [ 16 , 17 ]. They received chemoprophylaxis 1-h pre-operatively, including 1 gram of vancomycin.…”

Section: Methodsmentioning

confidence: 99%

Early Clinical and Radiographic Outcomes of Total Hip Arthroplasty with DELTA ST-C Cup and MINIMA S Stem

et al. 2023

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Background and Objectives: The uncemented threaded DELTA ST-C cup was introduced in last few years. It has a hemispheric shell, consisting of Ti6Al4V titanium alloy. The MINIMA S stem was developed according to the principles of proximal-loading and extended metaphyseal geometry applied to a short stem. The purpose of the study was to assess the clinical and radiographic outcomes and the short- and mid-term survivorship of the DELTA ST-C cup and MINIMA S stem in patients undergoing total hip arthroplasty (THA). The present is the first study to report outcomes and implant survivorship of the DELTA ST-C cup coupled with the MINIMA S femoral stem. Materials and Methods: The present study is a retrospective observational cohort study of a prospectively maintained database, evaluating clinical outcomes and implant survivorship in 95 patients undergoing THA with the MINIMA stem coupled with the DELTA ST-C cup with at least a 3-year follow-up. The clinical evaluation was assessed with a change in the Harris hip score (HHS), while the radiographic evaluation included anteroposterior views of the pelvis and lateral views of the affected hip. Results: The enrolled population’s mean age was 69.3 years and most patients were female (64%). The MINIMA S standard stem was implanted in 68 patients (72%), the lateralized stem was implanted in 27 (28%), and the mean acetabular inclination was 48.2°. The HHS improved significantly from the preoperative value (median 46, IQR: 38–55), already at 1 month after surgery (median 76, IQR: 66–77), reaching excellent results at 1 year and 3 years postoperatively (median 96, IQR: 91–100). X-rays demonstrated good implant stability and biomechanics parameter restorations revealed no sign of subsidence, and the presence of radiolucent lines greater than 2 mm in the short stem area in five cases and in the acetabulum in one were not clinically significant. No revisions have been performed so far. Conclusions: The MINIMA S stem coupled with the DELTA ST-C cup demonstrated very good clinical and radiological results with a significant increase of the Harris hip score at short- and mid-term follow-up. This is the first study evaluating the DELTA ST-C cup, showing promising outcomes during the study’s follow-up. The MINIMA S stem has been evaluated in a very few studies. However, the combination with this particular cup had not yet been studied. The design of the stem and the cup ensures primary stability and excellent early term outcomes, moreover the study demonstrates extraordinary implant survivorship, equal to 100%.

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Section: Methodsmentioning

confidence: 99%

Early Clinical and Radiographic Outcomes of Total Hip Arthroplasty with DELTA ST-C Cup and MINIMA S Stem

et al. 2023

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“…The ALMIS technique for THA was introduced in 2004 by Röttinger and in 2017 modified by Christodoulou [ 8 , 9 ]. More specifically, the positioning of the patient was changed, allowing for better visualization during preparation and the anterior ¼ of the GM was elevated, allowing easier access to the hip joint and the acetabulum.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the technique, it should be noted that no MIS instrumentation is necessary for the procedure, while all preparations and visualization of each anatomical region are carried out with standard tools and Hohmann retractors [ 9 , 10 ]. The positioning of the patient plays an important role, especially for the femoral preparation, while the external rotation of the lower limb during acetabular preparation enables adequate visualization.…”

Section: Discussionmentioning

confidence: 99%

“…The anterolateral minimally invasive surgery (ALMIS) for THA was initially described in 2004 by Röttinger and, later on, in 2017, modified by Christodoulou [ 7 , 8 , 9 ]. Röttinger introduced the “anterolateral” minimally invasive technique for total hip replacement, which involved employing the standard Watson-Jones interval.…”

Section: Introductionmentioning

confidence: 99%

“…However, a distinct intermuscular plane between the tensor fasciae latae (TFL) and the gluteus maximus (GM) was created without any muscle or tendon incisions or detachment [ 7 , 8 ]. In the modified ALMIS approach, the anterior ¼ of the GM is retracted and the patient is positioned differently from the initially described technique [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Modified Anterolateral Minimally Invasive Surgery (ALMIS) for Total Hip Replacement: Anatomical Considerations, Range of Motion and Clinical Outcomes

Koutserimpas,

Piagkou,

Karaiskos

et al. 2023

Medicina

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Background and Objectives: In the modified anterolateral minimally invasive surgery (ALMIS) for total hip arthroplasty (THA), the intermuscular plane between the tensor fasciae latae and the gluteus maximus (GM) is exposed, while the anterior ¼ of the GM is detached. There are scarce data regarding this surgical approach. The purpose of the present study is to thoroughly describe this approach, encompassing the anatomical background, and to present the results of a retrospective two-center study of 603 patients. Materials and Methods: The present study includes a two-center retrospective observational cohort of 603 patients undergoing the ALMIS technique with minimum 5-year follow-up. Demographics were recorded, while range of motion (ROM) of the hip joint and the Harris Hip Score (HHS) were evaluated preoperatively, at 1, 3 and 12 months postoperatively and at the final follow-up (>5 years). Surgery-related complications were also recorded. Results: The studied population’s mean age was 69.4 years, while most of them were females (397; 65.8%). The mean follow-up was 6.9 years. The median HHS at the 1-month follow-up was 74, compared to the 47 preoperatively (p-value < 0.0001). At the final follow-up, median HHS was 94. At the 1-month follow-up, mean adduction was 19.9° (compared to 15.4° preoperatively; p < 0.0001), mean abduction 24.3° (18.2° preoperatively; p < 0.0001), mean flexion 107.8° (79.1° preoperatively; p < 0.0001), mean external rotation 20.1° (12.1° preoperatively; p < 0.0001) and mean internal rotation 15.3° (7.2° preoperatively; p < 0.0001). ROM further improved until the final follow-up; mean adduction reached 22°, mean abduction 27.1°, mean flexion 119.8°, mean external rotation 24.4° and mean internal rotation 19.7°. Regarding complications, 1.3% of the sample suffered anterior traumatic dislocation, in 1.8% an intraoperative femoral fracture occurred, while 1.2% suffered periprosthetic joint infection. Conclusions: The modified ALMIS technique exhibited excellent clinical outcomes at short-, mid- and long-term follow-up, by significantly improving hip ROM and the HHS. Careful utilization of this technique, after adequate training, should yield favorable outcomes, while minimal major complications should be expected.

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ALMIS Anterolateral Hip Approach Using a Different Table and Legs Position during Femoral Exposure; New Surgical Technique

Cited by 3 publications

References 11 publications

Early Clinical and Radiographic Outcomes of Total Hip Arthroplasty with DELTA ST-C Cup and MINIMA S Stem

Early Clinical and Radiographic Outcomes of Total Hip Arthroplasty with DELTA ST-C Cup and MINIMA S Stem

Modified Anterolateral Minimally Invasive Surgery (ALMIS) for Total Hip Replacement: Anatomical Considerations, Range of Motion and Clinical Outcomes

New Generation Titanium Biologically Fixed Threaded Implants in Jawbone and Hip Joint

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