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Anterior Supine Intermuscular Approach in Total Hip Arthroplasty

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Minimally Invasive Surgery in Orthopedics

Abstract

As societal pressure for decreased cost and improvement in postoperative rehabilitation has increased, so has the interest in minimally invasive techniques for total hip arthroplasty (THA). The direct anterior approach (DAA) on the fracture table for THA has recently gained popularity. The use of a specialized table has been associated with unique complications (i.e., ankle fractures) and does not easily allow for an intraoperative assessment of limb length and hip stability. In this chapter, the anterior supine intramuscular approach or DAA without the use of a fracture table will be reviewed, including the history of the DAA, specifics of the ASI technique, pearls and pitfalls, outcomes, and complications. This approach provides a safe and reliable approach for THA with improved recovery rates in the postoperative period.

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References

  1. Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780.

    Article  PubMed  Google Scholar 

  2. Rachbauer F, Kain MS, Leunig M. The history of the anterior approach to the hip. Orthop Clin N Am. 2009;40(3):311–20.

    Article  Google Scholar 

  3. Smith-Petersen MN. A new supra-articular subperiosteal approach to the hip joint. Am J Orthop (Phila Pa). 1917;15:593.

    Google Scholar 

  4. Smith-Peterson MN. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg. 1949;31A:40.

    Google Scholar 

  5. Judet J, Judet R. The use of an artificial femoral head for arthroplasty of the hip joint. J Bone Joint Surg. 1950;32B:166.

    Google Scholar 

  6. Light TR, Keggi KJ. Anterior approach to hip arthroplasty. Clin Orthop. 1980;152:255.

    PubMed  Google Scholar 

  7. Kennon RE, Keggi JM, Wetmore RS, et al. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am. 2003;85 Suppl 4:39–48.

    PubMed  Google Scholar 

  8. Kennon R, Keggi JM, Zatorski LE, Keggi KJ. Anterior approach for total hip arthroplasty: beyond the minimally invasive technique. J Bone Joint Surg Am. 2004;86 Suppl 2:91–7.

    PubMed  Google Scholar 

  9. Alecci V, Valente M, Crucil M, et al. Comparison of primary total hip replacements performed with a direct anterior approach versus the standard lateral approach: perioperative findings. J Orthop Traumatol. 2011;12(3):123–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bhandari M, Matta JM, Dodgin D, et al. Outcomes following the single-incision anterior approach to total hip arthroplasty: a multicenter observational study. Orthop Clin N Am. 2009;40(3):329–42.

    Article  Google Scholar 

  11. Bender B, Nogler M, Hozack WJ. Direct anterior approach for total hip arthroplasty. Orthop Clin N Am. 2009;40(3):321–8.

    Article  Google Scholar 

  12. Berend KR, Lombardi Jr AV, Seng BE, et al. Enhanced early outcomes with the anterior supine intermuscular approach in primary total hip arthroplasty. J Bone Joint Surg Am. 2009;91 Suppl 6:107–20.

    Article  PubMed  Google Scholar 

  13. Bergin PF, Doppelt JD, Kephart CJ, et al. Comparison of minimally invasive direct anterior versus posterior total hip arthroplasty based on inflammation and muscle damage markers. J Bone Joint Surg Am. 2011;93(15):1392–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bremer AK, Kalberer F, Pfirrmann CW, Dora C. Soft-tissue changes in hip abductor muscles and tendons after total hip replacement: comparison between the direct anterior and the transgluteal approaches. J Bone Joint Surg (Br). 2011;93(7):886–9.

    Article  CAS  Google Scholar 

  15. Goebel S, Steinert AF, Schillinger J, et al. Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach. Int Orthop. 2012;36(3):491–8.

    Article  PubMed  Google Scholar 

  16. Horne PH, Olson SA. Direct anterior approach for total hip arthroplasty using the fracture table. Curr Rev Musculoskelet Med. 2011;4(3):139–45.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lovell TP. Single-incision direct anterior approach for total hip arthroplasty using a standard operating table. J Arthroplasty. 2008;23(7):64–8.

    Article  PubMed  Google Scholar 

  18. Masonis J, Thompson C, Odum S. Safe and accurate: learning the direct anterior total hip arthroplasty. Orthopedics 2008; 31(12).

    Google Scholar 

  19. Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res. 2005;441:115–24.

    Article  PubMed  Google Scholar 

  20. Moskal JT. Anterior approach in THA improves outcomes. Affirms Orthop. 2011;34(9):e456–8.

    Google Scholar 

  21. Nakata K, Nishikawa M, Yamamoto K, et al. A clinical comparative study of the direct anterior with miniposterior approach: two consecutive series. J Arthroplasty. 2009;24(5):698–704.

    Article  PubMed  Google Scholar 

  22. Oinuma K, Eingartner C, Saito Y, et al. Total hip arthroplasty by a minimally invasive, direct anterior approach. Oper Orthop Traumatol. 2007;19(3):310–26.

    Article  PubMed  Google Scholar 

  23. Restrepo C, Parvizi J, Pour AE, et al. Prospective randomized study of two surgical approaches for total hip arthroplasty. J Arthroplasty. 2010;25(5):671–9.

    Article  PubMed  Google Scholar 

  24. Seng BE, Berend KR, Ajluni AF, et al. Anterior-supine minimally invasive total hip arthroplasty: defining the learning curve. Orthop Clin N Am. 2009;40(3):343–50.

    Article  Google Scholar 

  25. Siguier T, Siguier M, Brumpt B. Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip replacements. Clin Orthop Relat Res. 2004;426:164–73.

    Article  PubMed  Google Scholar 

  26. Yerasimides JG. Use of the Fitmore hip stem bone-preserving system for the minimally invasive anterior-supine approach in hip replacement. Am J Orthop (Belle Mead NJ). 2010;39(10):13–6.

    Google Scholar 

  27. Barrett WP, Turner SE, Leopold JP. Prospective randomized study of direct anterior vs postero-lateral approach for total hip arthroplasty. J Arthroplasty. 2013;28(9):1634–8.

    Article  PubMed  Google Scholar 

  28. Berend KR, Lombardi Jr AV, Mallory TH. Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients. Surg Technol Int. 2004;13:239–47.

    PubMed  Google Scholar 

  29. Mayr E, Nogler M, Benedetti MG, et al. A prospective randomized assessment of earlier functional recovery in THA patients treated by minimally invasive direct anterior approach: a gait analysis study. Clin Biomech (Bristol, Avon). 2009;24:812–8. doi:10.1016/j.clinbiomech.2009.07.010.

    Article  Google Scholar 

  30. de Verteuil R, Imamura M, Zhu S, Glazener C, Fraser C, Munro N, Hutchison J, Grant A, Coyle D, Coyle K, Vale L. A systematic review of the clinical effectiveness and cost-effectiveness and economic modelling of minimal incision total hip replacement approaches in the management of arthritic disease of the hip. Health Technol Assess 2008;12(26).

    Google Scholar 

  31. Sariali E, Leonard P, Mamoudy P. Dislocation after total hip arthroplasty using Hueter anterior approach. J Arthroplasty. 2008;23(2):266–72.

    Article  PubMed  Google Scholar 

  32. Goulding K, Beaulé PE, Kim PR, Fazekas A. Incidence of lateral femoral cutaneous nerve neuropraxia after anterior approach hip arthroplasty. Clin Orthop Relat Res. 2010;468(9):2397–404.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Jewett BA, Collis DK. High complication rate with anterior total hip arthroplasties on a fracture table. Clin Orthop Relat Res. 2011;469(2):503–7.

    Article  PubMed  Google Scholar 

  34. Berend KR, Kavolus JJ, Morris M, et al. Primary and revision anterior supine total hip arthroplasty: an analysis of complications and reoperations. Instr Course Lect. 2013;62:251–63.

    PubMed  Google Scholar 

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Correspondence to Andrew B. Richardson .

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© 2016 Springer International Publishing Switzerland

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Richardson, A.B., Morris, M.J. (2016). Anterior Supine Intermuscular Approach in Total Hip Arthroplasty. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-319-34109-5_41

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  • DOI: https://doi.org/10.1007/978-3-319-34109-5_41

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34107-1

  • Online ISBN: 978-3-319-34109-5

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