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

Refai, Helmy Fekry; Kassem, Mohamed S

doi:10.1016/j.ajme.2013.09.004

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…There were 11 incidences of lateral femoral cutaneous nerve injury reported in seven standard table studies (1.1%, n = 937), and 48 incidences in four traction table studies (0.8%, n = 5672). 9,11,52,56 There were 30 incidences of femoral nerve palsy in 8 standard table studies (0.4%, n = 6734) 32,37,38,[40][41][42]46,47 and 0 incidences in the 4 traction table studies (n = 5672). 9,11,29,52…”

Section: Complicationsmentioning

confidence: 97%

“…In standard table studies, intraoperative fluoroscopy was used in 93.6% (3288/3512) of patients in the 7 studies (n = 3512) that reported its use. 14,33,37,40,44,45,48 In comparison, intraoperative fluoroscopy was used in 96.9% (10,870/11,220) of patients in the 16 traction table studies that reported it. 5,7,9,11,[50][51][52][55][56][57][58][59][60][61][62][63] In 15 standard table studies reporting specific implants (n = 4130), there were 54 (1.3%) cemented femoral implants used 26,42 and 4076 (98.7%) cementless femoral implants used.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…5,7,9,11,[50][51][52][55][56][57][58][59][60][61][62][63] In 15 standard table studies reporting specific implants (n = 4130), there were 54 (1.3%) cemented femoral implants used 26,42 and 4076 (98.7%) cementless femoral implants used. 14,26,29,33,[36][37][38][39][40][41][42][43][44][45]48 In 11 traction table studies that reported specific implants (n = 7189), there were 76 (1.0%) cemented femoral implants 9,54,59 and 7351 (99.0%) cementless femoral implants used. 7,9,11,50,52,55,56,60,63 Quality assessment MINORS scores indicated fair quality with a mean score for standard Mean body mass index (BMI) was reported in 9 standard table studies with a mean BMI of 29.5 ± 7.3 kg/m 2 (n = 3,487).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Traction table versus standard table total hip arthroplasty through the direct anterior approach: a systematic review

et al. 2020

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Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) was originally performed with a supine patient on a specialised traction table, but the approach can also be performed on a standard operating table. Despite cost and safety implications, there are few studies directly comparing these techniques and table choice remains largely surgeon preference. The purpose of this review was to compare the clinical outcomes and complication profiles of traction and standard table DAA for primary THA. Methods: The authors searched databases for relevant studies, screening in duplicate. Study quality was assessed using MINORS criteria or Cochrane Risk of Bias Tool. Data pertaining to patient demographics, clinical outcomes, and complications were abstracted. Results: Of 3085 initial titles, 44 studies containing a total 26,353 patients were included and analysed. Mean operative time was 70.9 ± 21.2 minutes for standard table ( n = 4402) and 100.1 ± 32.6 minutes for traction table ( n = 3518). Mean estimated blood loss was 382.3 ± 246.4 mL for standard ( n = 2992) and 531.7 ± 364.3 mL for traction table ( n = 2675). Intra-operative fracture rate was 1.3% for standard table ( n = 3940) and 1.7% for traction table ( n = 8386). Complication rates including revisions, dislocations and peri-prosthetic fractures were qualitatively similar between traction and standard table studies. Conclusion: Standard table and traction table DAA have similar outcomes and complications. Both techniques offer the short-term advantages of DAA when compared to other THA approaches. However, the standard table technique may offer perioperative advantages including decreased blood loss, shorter operative time, and fewer intraoperative fractures. In the context of rising global healthcare costs and lack of access to specialised orthopaedic traction tables, this review at minimum confirms the short-term safety of standard table DAA THA and prompts the need for future studies to directly compare these techniques.

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Section: Complicationsmentioning

confidence: 97%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Traction table versus standard table total hip arthroplasty through the direct anterior approach: a systematic review

et al. 2020

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Total hip replacements following acetabular fractures. 7 to 15 years clinical and radiological results

Kassem¹,

El-Sayed²

2021

Acta Orthop Belg

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This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirty patients (66.7%) needed autogenous acetabular bone grafting. There has been a statistically significant improvement from a preoperative mean Oxford hip score of 16 to a postoperative mean score of 39.8 (p < 0.001). At the end of follow up, two cases had revision for cup loosening. The complications included one case of transient sciatic nerve palsy, and two cases of heterotopic ossification. Currently, total hip replacement remains the best option for end stage post traumatic arthritis. There are technical challenges associated with this replacement surgery which the surgeon should be aware of.

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

Cited by 2 publications

References 17 publications

Traction table versus standard table total hip arthroplasty through the direct anterior approach: a systematic review

Traction table versus standard table total hip arthroplasty through the direct anterior approach: a systematic review

Total hip replacements following acetabular fractures. 7 to 15 years clinical and radiological results

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