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The Direct Anterior Hip Replacement PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "THE DIRECT ANTERIOR HIP REPLACEMENT" by ANTHONY S UNGER, MD.

This medical PowerPoint presentation is about direct anterior hip replacement, a surgical procedure used to replace a damaged or diseased hip joint with an artificial joint. It is a minimally invasive technique that involves making a small incision at the front of the hip joint, allowing the surgeon to access the joint without detaching any muscles or tendons.

During the surgery, the surgeon removes the damaged or diseased parts of the hip joint and replaces them with an artificial joint made of metal, plastic, or ceramic components. The artificial joint is designed to mimic the natural movement of the hip joint, allowing patients to regain their mobility and reduce pain.

The direct anterior hip replacement has several advantages over traditional hip replacement surgeries. It typically involves less pain and a shorter recovery time, as the technique does not require detaching any muscles or tendons. Patients may also experience fewer complications and have a reduced risk of dislocation or leg length discrepancy.

However, not all patients are suitable candidates for this procedure. Patients with significant hip deformities or severe osteoporosis may not be suitable candidates for direct anterior hip replacement. It is important to consult with a qualified orthopedic surgeon to determine the best treatment option for your individual case.

Tags : direct anterior hip replacement, hip joint, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 23, 2023 | Views : 1561 | Downloads : 0

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Slide 1-

THE DIRECT ANTERIOR HIP REPLACEMENT ANTHONY S UNGER, MD
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ANTHONY S UNGER, MD DISCLOSURES INNOMED—ROYALTIES BIOMET– ROYALTIES,CONSULTANT STRYKER—CONSULTANT, SPEAKER MEDTRONIC—SPEAKER CORMET—RESEARCH GRANT
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Direct Anterior Approach THR History First described by Carl Hueter in Germany in ~ 1881 Hueter, C. Fünfte abtheilung: die verletzung und krankheiten des hüftgelenkes , neunundzwanzigstes capitel. In: Hueter C, editor. Grundriss der chirurgie. 2nd edition. Leipzig; FCW Vogel; 1882. P 129-200.
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Direct Anterior Approach THR History Use of the DAA in hip arthroplasty began with Smith Petersen Smith Petersen, MN. A new supra-articular subperiosteal approach to the hip joint. JBJS Am 1917; s2-15: 592-5 Smith Petersen, MN. Approach to and exposure of the hip joint for mold arthroplasty. JBJS Am 1949; 31: 40-6 M. N. Smith Petersen
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DAA continued on in limited use for THR with the Judets brothers in France Judet J, Judet R. The use of an artificial femoral head for arthroplasty of the hip joint. JBJS Br 1950; 32B: 166-73 Judet J, Judet H. Voie d’abord anterieure dans l’arthroplastie totale de la hanche. Presse Med 1985; 14: 1031-3 Dr. Robert Judet and Dr. Jean Judet. Judet Acrylic Implant Direct Anterior Approach THR History
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Direct Anterior Approach THR History DAA continued on in limited use for THR with Kristaps Keggi in the US. Light TR, Keggi KJ. Anteior approach to hip arthoplasty. CORR 1980; 152: 255-60 Kennon RE, Keggi JM, Wetmore RS, et al. 2003. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg A 85:39–48. Kristaps Keggi
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Direct Anterior Approach THR History specialized orthopedic table, popularized by Joel Matta. Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthoplasty on an orthopaedic table. CORR 2005; 441: 115-24 Stefan Kreuzer MD, Kevin Leffers BS, Suneel Kumar MD. Direct Anterior Approach for Hip Resurfacing: Surgical Technique and Complications. CORR (2011) 469:1574–1581
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Rachbauer F, NoglerM, Mayr E, et al. Minimally invasive single incision anterior approach for total hip arthoplasty-early results. In: Hozack WJ, Krismer M, Nogler M, et al editiors. Minimally invasive total joint arthroplasty. Berlin: Springer; 2004. P. 54-9 Lovell T. Single incision direct anterior approach for total hip arthroplasty using a standard operating table. J arthroplasty; Volume 23, Issue 7, Pages 64-68, October 2008 The DAA in THR using a standard OR table. Direct Anterior Approach THR History Michael Nogler
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Direct Anterior Approach THR History The principles and basic technique of the approach are the same with or without the use of a specialized orthopedic table. The History of the anterior approach to the hip. Rachbauer F, Kain MS, Leung M. Orthop Clin North Am. 2009 Jul; 40(3): 311-20
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Direct Anterior Approach Scientific Basis Multiple Authors Have Proposed DAA THR Has: Less Soft Tissue Damage Faster & Easier Recovery Lower Dislocation Risk Is There Data For These Claims? Anterior Approach in THA Improves Outcomes: Affirms. JOSEPH T. MOSKAL, Orthopedics, SEPTEMBER 2011 | Volume 34 • Number 9
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DAA Has Less Soft Tissue Damage More Abductor Damage With Posterior Approach Than With Direct Anterior Approach The posterior approach had measurable damage to the abductor muscles and gluteus minimus tendon in each specimen Meneghini RM, Pagnano MW, Trousdale RT, Hozack WJ. Muscle damage during MIS total hip arthroplasty: Smith-Petersen versus posterior approach. Clin Orthop Relat Res. 2006;453:293–8
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ppt slide no 12 content not found
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Creatine Kinase Differences between Anterior and Posterior MIS THA
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Creatine Kinase Differences between Anterior and Posterior MIS THA 5.5X 1.4X 1.8X
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Creatine Kinase Differences between Anterior and Posterior MIS THA
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Creatine Kinase Differences between Anterior and Posterior MIS THA
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DAA Recovery May Be Faster & Easier A prospective, randomized study compared DL THA and DAA approach THA. Using numerous validated outcome measures the DAA THA had significantly better improvements at 6 weeks, 6 months, and 1 year than did the direct lateral approach THA. Restrepo C, Parvizi J, Pour AE, Hozack WJ. Prospective randomized study of two surgical approaches for total hip arthroplasty J Arthroplasty. 2010; 25(5):671-679.e1.
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DAA Recovery May Be Faster & Easier A prospective, randomized IRB-approved clinical study comparing DAA to Posterior THA CONCLUSIONThe DAA cohort required less post-op pain medication, half-day shorter hospitalization and patients had higher functional scores at one and three months. Prospective Randomized Study of Anterior vs. Postero-lateral Approach for Total Hip Arthroplasty. William P. Barrett, Shelly Turner. Session 44-Adult Reconstruction Hip VI, paper 655. AAOS 2012.
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DAA Has A Lower Dislocation Rate Sariali, E., P. Leonard, and P. Mamou J Arthroplasty, 2008. 23(2): p. 266–72. dy, Dislocation after total hip arthroplasty using Hueter anterior approach. Appproach Number of THRs Dislocation Rate Posterior 10187 4% Transtrochanteric 1052 1.6% Anterolateral 7473 2%
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DAA Has A Lower Dislocation Rate Direct anterior approach for total hip arthroplasty using the fracture table. Phillip H. Horne & Steven A. Olson. Curr Rev Musculoskelet Med (2011) 4:139–145 1% Dislocation Rate For DAA THR Using A Fracture Table
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DAA ADVANTAGES PATIENT SUPINE—LL EQUALIZATION LOWER DISLOCATION RATE LESS INVASIVE ? OBESE PATIENTS EASIER LESS DVT??—LESS KINKING OF FEMORAL VEIN
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DAA-TABLE-LESS ADVANTAGES QUICKER, LESS SET UP BETTER ASSESSMENT OF STABILITY CHEAPER—NO TABLE COSTS BETTER ABILITY TO EQUAL LL DON’T NEED XRAY
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DAA-TABLE-LESS DISADVANTAGES NEED 2ND ASSISTANT NO MARKETING OF TABLE NEED GOOD SURGICAL EXPOSURE NO XRAY TO ASSESS FEMORAL COMPONENT
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MY SERIES 2005-2013 750 HIPS DISLOCATIONS=4 LOOSE STEM=1 FRACTURE=1 INFECTION=1 AVG LOS =2 DAYS
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56 yo male, Hx of Femur FX, R Hip pain
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RTHA DAA Intra op xray
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RTHA DAA Post op
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55 yo MD Bilat DJD HIP undergoes L-THA DAA
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POST-OP R-THA after XRT
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THANK YOU