Elsevier

The Journal of Arthroplasty

Volume 24, Issue 7, October 2009, Pages 999-1005
The Journal of Arthroplasty

Primary Total Hip Arthroplasty Using an Anterior Approach and a Fracture Table: Short-term Results From a Community Hospital

https://doi.org/10.1016/j.arth.2009.04.001Get rights and content

Abstract

There are no data regarding the efficacy and safety of minimally invasive hip arthroplasty technique performed by community practice orthopedists. The early clinical and radiographic results of primary total hip arthroplasty using a minimally invasive anterior approach to the hip performed on a fracture table were studied. Two hundred thirty-one consecutive patients (247 hips) of 5 community practice surgeons were studied. The average surgical time (164 minutes) and estimated blood loss (858 mL) were more than double, and the major complication rate (9%) was 6 times that reported by an innovator of the procedure. However, no postoperative dislocations occurred. Adequate training is critical to reduce the risk of complications during the learning experience of minimally invasive hip arthroplasty procedures by community practice surgeons.

Section snippets

Materials and Methods

The short-term results of a consecutive series of the patients of 5 surgeons who underwent primary total hip arthroplasty from an anterior approach using a fracture table for a period of 2 years were studied. Four of the 5 community practice surgeons at one hospital began using this new minimally invasive procedure exclusively for all of their primary hip arthroplasty procedures after October 2004, and the remaining surgeon started to use the technique in October 2005. All of these surgeons had

Results

The average surgical time was extremely long at 164 minutes, and the average surgical estimated blood loss was also high (858 mL), with an average length of stay of 3.2 days. These patients received an average of 2.4 U of blood postoperatively, with most of the patients receiving 1 to 3 predonated autologous units (average, 1.7 U) (Table 3). Seventy-two percent of the patients were discharged home, 96% were not restricted in weight bearing, and no patient was asked to observe dislocation

Discussion

There have been few reports of the results of minimally invasive hip arthroplasty performed by noninnovators 3, 4, 11, 12 and no publications of the results of minimally invasive hip arthroplasty performed by community practice surgeons. This study was intended to determine the early postoperative outcomes of a minimally invasive total hip procedure in a consecutive series of patients at a single community hospital. It is important to determine the results of minimally invasive hip arthroplasty

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  • Is Surgical Approach for Primary Total Hip Arthroplasty Associated With Timing, Incidence, and Characteristics of Periprosthetic Femur Fractures?

    2021, Journal of Arthroplasty
    Citation Excerpt :

    An additional, potential reason for earlier fractures in the DA cohort is due to the predilection for implanting undersized stems through this approach. This issue has been evaluated in the literature and leads to postoperative subsidence with subsequent “atraumatic” PFFs, almost all of which occur in the early postoperative period [15,24,40–42]. Despite these factors that can cause earlier PFF in the DA approach, we found that the overall incidence of PFF between DA, PA, and LA approaches was similar (Table 1).

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No benefits or funds were received in support of the study.

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