Bertrand Kaper
Orthopaedic Specialists of Scottsdale, USA
Biography:
Abstract:
Introduction: The technique of direct anterior total hip arthroplasty (DA THA) has increased in popularity. The benefits of DA THA have been debated. One of the reported advantages has been the reduction in the complication risk of postoperative dislocation. The rate of dislocation in a single-surgeon DA THA patient cohort was assessed in this study.
Materials and Methods: From October 2012 through October 2018, all patients undergoing primary THA via a direct anterior approach were prospectively enrolled in this study. Baseline data, including age, gender, BMI was recorded for all subjects. Operative data, including surgical times, implant information, and implant position, was recorded for all cases Surgical technique was consistent across all cases. All cases were performed in the supine position on the HANA table, with the use of intra-operative fluoroscopy. Anesthetic technique, multi-modality pain management protocol, and post-operative mobilization was consistent for all patients enrolled in the study. Dislocation occurrence within the first twelve months postoperatively was recorded for all patients retrospectively.
Results: No patients were lost to follow up during the twelve-month study period. Patient demographics were similar to previously reported THA study cohorts. Average surgical time was 51.0 minutes (range 34-87 minutes). Average acetabular cup position noted 42.4 degrees of abduction and 23.3 degrees of anteversion. The dislocation rate recorded in this study was 0.08% (1/1220).
Discussion/Conclusions: Dislocation rates after primary THA have been reported between 1-3%. This study demonstrates a postoperative dislocation risk of 0.08% associated with the DA THA technique, utilizing intra-operative fluoroscopy. This rate is significantly lower than previously reported for any surgical approach. Further, the experience in DA THA reported in this study showed no “learning curve” in regard the risk of dislocation.