Why the Direct Anterior Approach for THA
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This document discusses the direct anterior approach for total hip arthroplasty. It lists advantages of the direct anterior approach such as increased stability, easier leg length equalization, lower costs by not requiring an operating table, reduced radiation exposure, faster rehabilitation, and lower risk of deep vein thrombosis. The document also discusses the historical background of the direct anterior approach, showing it has been performed since the 1880s. It presents images showing fatty degeneration of muscles and gluteal atrophy after total hip arthroplasty. Finally, it displays graphs comparing outcomes and improvements in quality of life domains between the direct anterior approach and minimally invasive approaches.
Why the Direct Anterior Approach for THA
- 1. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria ANTHONY S UNGER, MD PROFESSOR OTHOPAEDIC SURGERY GEORGE WASHINGTON UNIVERSITY
- 2. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria Why the Direct Anterior Approach for THA
- 3. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria DAA ADVANTAGES-WITHOUT TABLE STABILITY **** LEG LENGTH EQUALIZATION **** NO TABLE COSTS *** NO XRAY ** FASTER REHAB ** LESS DVT *
- 4. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria Fatty Degeneration of the Muscle Source: Pfirrmann CW, Notzli HP, Dora C, Hodler J, Zanetti M. 2005. Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology 235:969-976.
- 5. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria Havlik Angelika Glutealatrophie
- 6. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria Approaches
- 7. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria 1. Karl Hüter 1880 2. Smith-Petersen NM. A new supra- articular subperiosteal approach to the hip joint. Am J Orthop Surg 15:592 3. Smith-Peterson NM. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg Am 31:40 4. Wagner H. Surface replacement arthroplasty of the hip. Clin Orthop 134:102 5. Keggi K. Anterior Approach THA Via Mini-Incision Technique. Joint Implant Surgery & Research Foundation Historical Background of the DAA
- 8. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria Historical Background of the DAA
- 9. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria 0 20 40 60 80 100 Physical functioning Role physical Bodily pain General health Vitality Social functioning Role emotional Mental health MISdv t-glut p < 0.05 16 vs 36 Points Improvement Outcomes
- 10. Medical University Innsbruck, AustriaMedical University Innsbruck, Austria 0 20 40 60 80 100 Physical functioning Role physical Bodily pain General health Vitality Social functioning Role emotional Mental health MISdv t-glut p < 0.05 16 vs 36 Points Improvement Outcomes
Editor's Notes
- #5: Fettige Atrophie des M. gluteus med. nur in der symptomatischen Gruppe! Fatty atrohpy of the M. gluteus med. only in the symptomatic group!
- #7: The direct anterior approach utilizes the interval between tensor fasciae latae and sartorius as well as the rectus femoris. It is, like the Watson-Jones interval (between tensor and gluteus medius), one of the two truly intermuscular intervals. But unlike the Watson-Jones interval, it is also truly internerval because all the muscles located medially to the interval are supplied by the femoral nerve, and all muscles located laterally are supplied by the superior gluteal nerve.
- #10: SF-36 Vergleich MIS DAA gegen Lateral