The mini postero-postero-lateral mini incision in total hip arthroplasty

Jacquot, Frédéric; Mokhtar, Mokrane Ait; Sautet, Alain; Doursounian, Levon; Masquelet, Alain-Charles; Féron, Jean-Marc

doi:10.1007/s00264-013-1970-x

Cited by 9 publications

(10 citation statements)

References 37 publications

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“…The intraoperative blood loss (Table 6 ) is comparable to other approaches which showed an average of 385 ml – 921 ml [ 2 , 3 , 23 ]. This might prove that the amount of blood loss is not directly related to one approach.…”

Section: Discussionsupporting

confidence: 52%

“…Jacquot et al [ 23 ] described for a modified postero-postero-lateral approach zero dislocation out of one-hundred and two treated femoral neck fractures after a six weeks follow-up. It is not known if after a longer follow-up period dislocations could occur.…”

Section: Discussionmentioning

confidence: 99%

“…No pulmonary embolisms or deep vein thrombosis were observed in this study. In the literature, a rate of pulmonary embolism of 0-5.8 % [ 2 , 3 , 10 , 23 , 35 ] and a deep vein thrombosis rate of 0-6 % [ 3 , 23 , 35 ] are described (Table 9 ). We guess this good result is due to early mobilization with allowed full immediate weight-bearing combined with anticoagulant-treatment in prophylactic dosage.…”

Section: Discussionmentioning

confidence: 99%

“…In ambulatory patients, total hip replacement is the preferred treatment, given its more favorable long-term outcome [ 2 – 10 ]. In terms of approach – direct anterior approach [ 11 – 16 ], anterolateral approach [ 17 , 18 ], lateral approach [ 19 , 20 ], posterolateral approach [ 21 ], posterior approach [ 17 , 22 , 23 ], 2-incision approach [ 17 ] – the methods are often chosen independently of scientific studies and often depend on the local economic and social conditions and/or preferences of surgeons.…”

Section: Introductionmentioning

confidence: 99%

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Safety of total hip arthroplasty for femoral neck fractures using the direct anterior approach: a retrospective observational study in 86 elderly patients

et al. 2016

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BackgroundThe femoral neck fracture is one of the most common fractures in the elderly. A variety of methods and approaches are used to treat it. Total hip arthroplasty is a preferred approach in independent, mobile, elderly patients, given its more favorable long-term outcome.Our hypothesis is that the direct anterior approach in geriatric trauma patients has a lower dislocation-rate with the advantage of early recovery due to a muscle sparing approach and therefore early possible full weight-bearing.MethodsPatients were retrospectively sought who suffered a femoral neck fracture from 2008 to 2013. All patients were treated through a direct anterior approach and using the same brand of implants. Medical history, standardized physical exam, conventional pelvic plain and axial hip x-rays, Harris Hip Score, Merle D'Aubigné and Postel and SF-36 were assessed.ResultsEighty-six patients were included in the study with a mean age of seventy-five years. The mortality rate was 16.7 %. Complications were encountered in nineteen patients (22.0 %) who needed operative revision and one postoperative complication (1.2 %) which could be handled conservatively. There were five intraoperative complications (5.8 %), two dislocations (2.3 %), one aseptic loosening in a non-cemented stem (1.2 %), six periprosthetic fractures in non-cemented stems (6.9 %), one displacement of a non-cemented cup (1.2 %), two early infections (2.3 %) and three hematomas (3.5 %) recorded.ConclusionsAlthough the direct anterior approach is associated with a rather long learning curve we have found it to preserve the soft-tissues with no injury to abductors. It therefore shows an early advantage in elderly patients in terms of early recovery and therefore early possible full weight-bearing. Fracture treatment with dual mobility cups might lead to lower dislocation rates, but are associated with higher costs. Due to higher complication rates in non-cemented versus cemented shafts, we have changed our practice towards favoring cemented femoral stems in patients with suspected or manifest osteoporosis.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Safety of total hip arthroplasty for femoral neck fractures using the direct anterior approach: a retrospective observational study in 86 elderly patients

et al. 2016

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“…If a surgeon wishes to adopt a technology that assists with component positioning, and chooses fluoroscopy, using the direct anterior approach would make that technology more effective. There are other considerations in choosing an approach [21,[33][34][35][36][37][38][39], but these findings may factor into that discussion.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy assessment during anterior minimally invasive hip replacement is more accurate than with the posterior approach

Stewart

2015

International Orthopaedics (SICOT)

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Using fluoroscopy in the direct anterior approach, we achieved better intra-operative assessment of cup orientation resulting in decreased variability of acetabular cup anteversion than when used in the posterior approach. At least some of the improvement was due to the fact that the fluoroscopic image in the supine position was more accurate as measured against the postoperative standing AP pelvis. This study may influence the choice of approach in total hip replacement.

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Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty

Reichert

Volkmann

Koppmair

et al. 2015

International Orthopaedics (SICOT)

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The mini postero-postero-lateral mini incision in total hip arthroplasty

Abstract: The method and skin landmarks we describe appear to be a safe way to perform minimally invasive total hip replacement.

Cited by 9 publications

References 37 publications

Safety of total hip arthroplasty for femoral neck fractures using the direct anterior approach: a retrospective observational study in 86 elderly patients

Safety of total hip arthroplasty for femoral neck fractures using the direct anterior approach: a retrospective observational study in 86 elderly patients

Fluoroscopy assessment during anterior minimally invasive hip replacement is more accurate than with the posterior approach

Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty

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