High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach

被引:213
作者
Spaans, Anne J. [1 ]
van den Hout, Joost A. A. M. [1 ]
Bolder, Stefan B. T. [1 ]
机构
[1] Amphia Hosp, Dept Orthopaed Surg, Breda, Netherlands
关键词
REPLACEMENT;
D O I
10.3109/17453674.2012.711701
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background and purpose There is growing interest in minimally invasive surgery techniques in total hip arthroplasty (THA). In this study, we investigated the learning curve and the early complications of the direct anterior approach in hip replacement. Methods In the period January through December 2010, THA was performed in 46 patients for primary osteoarthritis, using the direct anterior approach. These cases were compared to a matched cohort of 46 patients who were operated on with a conventional posterolateral approach. All patients were followed for at least 1 year. Results Operating time was almost twice as long and mean blood loss was almost twice as much in the group with anterior approach. No learning effect was observed in this group regarding operating time or blood loss. Radiographic evaluation showed adequate placement of the implants in both groups. The early complication rate was higher in the anterior approach group. Mean time of hospital stay and functional outcome (with Harris hip score and Oxford hip score) were similar in both groups at the 1-year follow-up. Interpretation The direct anterior approach is a difficult technique, but adequate hip placement was achieved radiographically. Early results showed no improvement in functional outcome compared to the posterolateral approach, but there was a higher early complication rate. We did not observe any learning effect after 46 patients.
引用
收藏
页码:342 / 346
页数:5
相关论文
共 22 条
[1]
Comparison of primary total hip replacements performed with a direct anterior approach versus the standard lateral approach: Perioperative findings [J].
Alecci V. ;
Valente M. ;
Crucil M. ;
Minerva M. ;
Pellegrino C.-M. ;
Sabbadini D.D. .
Journal of Orthopaedics and Traumatology, 2011, 12 (3) :123-129
[2]
Direct Anterior Approach for Total Hip Arthroplasty [J].
Bender, Benjamin ;
Nogler, Michael ;
Hozack, William J. .
ORTHOPEDIC CLINICS OF NORTH AMERICA, 2009, 40 (03) :321-+
[3]
Comparison of Minimally Invasive Direct Anterior Versus Posterior Total Hip Arthroplasty Based on Inflammation and Muscle Damage Markers [J].
Bergin, Patrick F. ;
Doppelts, Jason D. ;
Kephart, Curtis J. ;
Benke, Michael T. ;
Graeter, James H. ;
Holmes, Andrew S. ;
Haleem-Smith, Hana ;
Tuan, Rocky S. ;
Unger, Anthony S. .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2011, 93A (15) :1392-1398
[4]
Minimally invasive total hip arthroplasty: a systematic review [J].
Cheng, T. ;
Feng, J. G. ;
Liu, T. ;
Zhang, X. L. .
INTERNATIONAL ORTHOPAEDICS, 2009, 33 (06) :1473-1481
[5]
Learning curve in tissue sparing total hip replacement: Comparison between different approaches [J].
D'Arrigo C. ;
Speranza A. ;
Monaco E. ;
Carcangiu A. ;
Ferretti A. .
Journal of Orthopaedics and Traumatology, 2009, 10 (1) :47-54
[6]
Dorr LD, 1998, CLIN ORTHOP RELAT R, P144
[7]
Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty [J].
Goulding, Krista ;
Beaule, Paul E. ;
Kim, Paul R. ;
Fazekas, Anna .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (09) :2397-2404
[8]
Minimally invasive hip replacement: rationale, applied anatomy, and instrumentation [J].
Howell, JR ;
Garbuz, DS ;
Duncan, CP .
ORTHOPEDIC CLINICS OF NORTH AMERICA, 2004, 35 (02) :107-+
[9]
Total Hip Arthroplasty: A Comparison of Current Approaches [J].
Krismer, Martin .
EUROPEAN INSTRUCTIONAL LECTURES, VOL 9, 2009, 2009, 9 :163-175
[10]
DISLOCATIONS AFTER TOTAL HIP-REPLACEMENT ARTHROPLASTIES [J].
LEWINNEK, GE ;
LEWIS, JL ;
TARR, R ;
COMPERE, CL ;
ZIMMERMAN, JR .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1978, 60 (02) :217-220