medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 1

<< Back Next >>

Acta Ortop Mex 2021; 35 (1)

Uncemented total hip arthroplasty by anterior approach. Report of the first 50 cases

Fernández-Palomo L

Language: Spanish
References: 19
Page: 17-22
PDF size: 248.47 Kb.


ABSTRACT

Introduction: The anterior direct approach to the hip has become popular in recent years, as it favors rapid recovery and better evolution, as well as shorter hospital stay time, painkiller consumption, physical therapy requirement and thus a possible overall reduced cost. The results of the first 50 cases are reported, with this technique assisted by the use of a special traction table. Material and methods: Retrospective study of 50 hip arthroplasties in 47 patients by said method and special table, between April 2018 and April 2020. Etiology, gender, affected age and side, surgical lapse, transoperative bleeding and implant size were recorded. Immediate clinical and radiographic evolution was evaluated at the start and during the first 90 days. Results: Sample of 18 men and 29 women. The average age was 67.7 years (range 28 to 94). Mean surgical time two hours 37 minutes, average bleeding 513 ml, clinical progress according to Harris scale: excellent 42 (84%), seven good (14%) and one bad (2%), due to infection. There were two calcar fractures without the need to remove an implant, eight cases of muscle mass injury, bruising in four (8%), femorocutaneous nerve paresis in six (12%), superficial infection two cases (4%). No dislocations. Conclusion: The anterior approach is a safe and reliable technique with immediate satisfactory outcomes and minor complications.


REFERENCES

  1. Nwachukwu BU, Bozic KJ, Schairer WW, Bernstein JL, Jevsevar DS, Marx RG, et al. Current status of cost utility analyses in total joint arthroplasty: a systematic review. Clin Orthop Relat Res. 2014; 473 (5): 1815-27.

  2. Meermans G, Konan S, Das R, Volpin A, Haddad FS. The direct anterior approach in total hip arthroplasty : a systematic review of the literature. Bone Joint J. 2017; 99-B(6): 732-40.

  3. Sheth DS, Cafri G, Inacio MC, Paxton EW, Namba RS. Anterior and anterolateral approaches for THA are associated with lower dislocation risk without higher revision risk. Clin Orthop Relat Res. 2015; 473(11): 3401-8.

  4. Villa JM, Pannu TS, Higuera CA, Suarez JC, Patel PD, Barsoum WK. Hospital adverse events and perioperative outcomes in bilateral direct anterior approach for total hip arthroplasty. J Artrhoplasty. 2020; 35(3): 762-66.

  5. Rahm S, Tondelli T, Steinmetz S, Schenk P, Dora C, Zingg P. Uncemented total hip arthroplasty through the direct anterior approach: Analysis of a consecutive series of 275 hips with a minimum follow-up of 10 years. J Arthroplasty. 2019; 34(6): 1132-38.

  6. Lee G, Marconi D. Complications following direct anterior hip procedures: costs to both patient and surgeons. J Arthroplasty. 2015; 30(9 Suppl): 98-101.

  7. Matta JM, Ferguson TA. The anterior approach for hip replacement. Orthopedics. 2005; 28: 927-8.

  8. Matta JM, Shahrdar C, Ferguson T. Single incision anterior approach for total hip arthroplasty on an orthopedic table. Clin Orthop Rel Res. 2005; 441: 115-24.

  9. Laude F. Total hip arthroplasty through an anterior Hueter minimally invasive approach. Interact Surg. 2006; 1: 5-11.

  10. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. And end result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 59: 737-55.

  11. Barnett SL, Peters DJ, Hamilton WG, Ziran NM, Gorab RS, Matta JM. Is the anterior approach safe? Early complication rate associated with 5090 consecutive primary total hip arthroplasty procedure performed using the anterior approach. J Arthroplasty. 2016; 31: 2291-4.

  12. Gofton WT, Ibrahim MM, Kreviazuk CJ, Kim PR, Feibel RJ, Beaulé PE. Ten year experience with the anterior approach to total hip arthroplasty at a tertiary center. J Arthroplasty. 2019; 35(5): 1281-89.e1.

  13. Charney M, Paxton EW, Stradiotto R, Lee JJ, Hunman AD, Sheth DS, Prentice HA. A comparison of risk of dislocation and cause-specific revision between direct anterior and posterior approach following elective cementless total hip arthroplasty. J Arthroplasty. 2020; 35: 1651-57.

  14. Meneghini RM, Elston AS, Chen AF, Kheir MM, Fehring TK, Springer BD. Direct anterior approach: risk factor for early femoral failure of cementless total hip arthroplasty. J Bone Joint Surg Am. 2017; 99(2): 99-105.

  15. Taunton MJ, Trousdale RT, Sierra RJ, Kaufman K, Pagnano MW. John Charnley Award: Randomized clinical trial of direct anterior and mini-posterior approach THA: which provides better functional recovery? Clin Orthop Relat Res. 2018; 476(2): 216-29.

  16. Siljander MP, Whaley JD, Koueiter DM, Alsaleh M, Karadsheh WS. Length of stay, discharge disposition, and 90-day complications and revisions following primary total hip arthroplasty: a comparison of the direct anterior, posterolateral and direct superior approaches. J Arthroplasty. 2020; 35(6): 1658-61.

  17. Higgins BT, Barlow DR, Heagerty NE, Lin TJ. Anterior vs posterior approach for total hip arthroplasty, a systematic review and meta-analysis. J Arthroplasty. 2015; 30(3): 419-34.

  18. Spaans AJ, van den Hout JA, Bolder SB. High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach. Acta Orthop Scand. 2012; 83(4): 342-6.

  19. Strassburger-Weidmann J, Vélez-de Lachica JC. Satisfacción del paciente operado de artroplastía primaria de cadera con abordaje anterior, lateral y posterior. Acta Ortop Mex. 2019; 33(6): 395-99.



EVIDENCE LEVEL

IV




2020     |     www.medigraphic.com