Direct Anterior Approach for Hip Resurfacing: Surgical Technique and Complications.
Summary of "Direct Anterior Approach for Hip Resurfacing: Surgical Technique and Complications."
BACKGROUND:
The direct anterior approach (DAA) for hip resurfacing arthroplasty is a technically difficult approach but theoretically reduces the soft tissue trauma to the hip because it does not require muscle detachments from the bone. Furthermore, the patient is in the supine position facilitating fluoroscopy to control component placement. However, the complications associated with the learning curve and functional outcome scores are not well defined in the literature. QUESTIONS/
PURPOSES:
We therefore asked how our first 57 operations using the anterior approach and special table extension compared with that in the literature with regard to (1) complication rate; (2) functional outcome scores; (3) component placement; and (4) length of stay.
METHODS:
We retrospectively reviewed 51 patients who underwent 57 hip resurfacing procedures using a DAA. There were 45 men and six women with an average age of 51 years (range, 31-63 years) and a body mass index of 28.7 kg/m(2) (range, 19.7-42.0 kg/m(2)). The minimum followup was 0.3 months (mean, 8.7 months; range, 0.3-24.9 months).
RESULTS:
There were three atraumatic (5%) and one posttraumatic (1.8%) femoral neck fractures. Average HOOS scores were equal to or better than averages reported for total hip arthroplasty. Average cup inclination was 36.5° (range, 25°-48°). The average length of stay was 2.11 days (range, 1-4 days).
CONCLUSIONS:
The surgical approach for anterior hip resurfacing is technically difficult but may have some clinical benefits. Surgeons interested in using the DAA for hip resurfacing should be very familiar with the DAA for total hip arthroplasty and with hip resurfacing. LEVEL OF
EVIDENCE:
Level IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence.
Affiliation
Memorial Bone and Joint Clinic, 1140 Business Center Drive, Suite 101, Houston, TX, 77043, USA, skreuzer@mbjc.net.
Journal Details
This article was published in the following journal.
Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21161743
- DOI: http://dx.doi.org/10.1007/s11999-010-1698-5
Medical and Biotech [MESH] Definitions
Postoperative Complications
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Intraoperative Complications
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Fluorescent Antibody Technique
Test for tissue antigen using either a direct method, by conjugation of antibody with fluorescent dye (FLUORESCENT ANTIBODY TECHNIQUE, DIRECT) or an indirect method, by formation of antigen-antibody complex which is then labeled with fluorescein-conjugated anti-immunoglobulin antibody (FLUORESCENT ANTIBODY TECHNIQUE, INDIRECT). The tissue is then examined by fluorescence microscopy.
Arthroplasty, Subchondral
Surgical techniques used to correct or augment healing of chondral defects in the joints (CARTILAGE, ARTICULAR). These include abrasion, drilling, and microfracture of the subchondral bone to enhance chondral resurfacing via autografts, allografts, or cell transplantation.
Gingivectomy
Surgical excision of the gingiva at the level of its attachment, thus creating new marginal gingiva. This procedure is used to eliminate gingival or periodontal pockets or to provide an approach for extensive surgical interventions, and to gain access necessary to remove calculus within the pocket. (Dorland, 28th ed)
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