Safety in early experience with a direct anterior approach using fluoroscopic guidance with manual leg control for primary total hip arthroplasty: a consecutive one hundred and twenty case series
| Autor: | Yasuhiro Homma, Mikio Matsumoto, Yu Ozaki, Hideo Kobayashi, Asuka Desroches, Hironori Ochi, Tomonori Baba, Kazuo Kaneko, Takahito Yuasa |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Arthroplasty Replacement Hip Patient Positioning 03 medical and health sciences 0302 clinical medicine medicine Humans Fluoroscopy Orthopedics and Sports Medicine 030212 general & internal medicine Aged Retrospective Studies 030222 orthopedics medicine.diagnostic_test business.industry Middle Aged Surgery Neutral position Orthopedic surgery Operative time Female Hip Joint Hip Prosthesis Patient Safety Anterior approach Joint Diseases Complication Early phase business Learning Curve Total hip arthroplasty |
| Zdroj: | International Orthopaedics. 40:2487-2494 |
| ISSN: | 1432-5195 0341-2695 |
| DOI: | 10.1007/s00264-016-3159-6 |
| Popis: | An encouraging result with direct anterior approach (DAA) is attractive for both patients and surgeons. However, the risks associated with beginning to use DAA require further analysis of the learning curve and better countermeasures to ensure safety. We ask whether the complication rate in the DAA by the inexperienced surgeon could be decreased with specific countermeasures. Our hypothesis was that the complication rate would be low even in early phase of the learning curve using the DAA with these particular countermeasures. We investigated a consecutive series of 120 primary THA using the DAA with four specific countermeasures; 1) defined exclusion criteria for DAA; 2) no positioning table; 3) use of fluoroscopy as much as required; and 4) having an experienced assistant for DAA (one who has performed the procedure in more than 100 cases). The operative time, the time of fluoroscopic use during the operation, intra and post-operative complications, re-operation for any reason, and cup and stem alignment were investigated. Although the operation times were similar, the duration of fluoroscopy decreased with surgeons’ experience. There were no intra-operative complications and no re-operations for any reason. One anterior dislocation was observed in one patient. The mean cup inclination and anteversion angle was 39.7° ± 7.6° and 30.3° ± 7.6°; 43.3 % of stems were positioned in flexion, 55.8 % in the neutral position on the lateral view. We demonstrated a lower complication rate during our early experience with the DAA using four countermeasures. Using these countermeasures for the first 40 cases may be useful for surgeons who are considering DAA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink