Kaitlyn D’Onofrio

DocwireNews

A recent retrospective study published in BMC Musculoskeletal Disorders compared complication rates and bleeding associated with the <a href="https://proddocwire.wpengine.com/abstracts/tranexamic-acid-total-hip-arthroplasty/">direct anterior approach</a> (DAA) and <a href="https://proddocwire.wpengine.com/abstracts/rheumatology-abstracts/lumbar-fusion-involving-the-sacrum-increases-dislocation-risk-in-primary-total-hip-arthroplasty/">anterolateral approach</a> in <a href="https://proddocwire.wpengine.com/abstracts/rheumatology-abstracts/cognitive-impairment-and-postoperative-outcomes-in-patients-undergoing-primary-total-hip-arthroplasty-a-systematic-review/">total hip arthroplasty</a> (THA).The study began with 1,408 <a href="https://proddocwire.wpengine.com/abstracts/rheumatology-abstracts/primary-total-hip-arthroplasty/">elective THA</a> patients from a single institution. From this cohort, researchers created two matching groups with 396 patients each. Matched patients had similar age, gender, body mass index (BMI), American Society of Anesthesiologists&rsquo; (ASA) score, and surgeon&rsquo;s experience.The overall average age for the matched groups was 68.7&thinsp;&plusmn;&thinsp;10.3&thinsp;years; 61.3% (n = 243) were female. Mean BMI was 28.1 &plusmn; 4.9 kg/m2. Most patients (n = 284, 71.7%) had an ASA score of 2, while 22.22% (n = 88) and 6.1% (n = 24) had a score of 3 and 1, respectively.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Zooming in on the Benefits of the Direct Anterior Approach to a Hip Replacement Procedure (<a href="https://t.co/lCWzv6KZbB">https://t.co/lCWzv6KZbB</a>)<a href="https://twitter.com/hashtag/hipreplacement?src=hash&amp;ref_src=twsrc%5Etfw">#hipreplacement</a> <a href="https://twitter.com/hashtag/hipreplacementprocedure?src=hash&amp;ref_src=twsrc%5Etfw">#hipreplacementprocedure</a> <a href="https://twitter.com/hashtag/anteriorapproachhipreplacement?src=hash&amp;ref_src=twsrc%5Etfw">#anteriorapproachhipreplacement</a> <a href="https://twitter.com/hashtag/orthopedicsurgeon?src=hash&amp;ref_src=twsrc%5Etfw">#orthopedicsurgeon</a> <a href="https://twitter.com/hashtag/houston?src=hash&amp;ref_src=twsrc%5Etfw">#houston</a>
&mdash; Ugo Ihekweazu, MD, FAAOS (@DrIhekweazu) <a href="https://twitter.com/DrIhekweazu/status/1095820264850538499?ref_src=twsrc%5Etfw">February 13, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>Perioperative non-compensated blood loss rates were similar among the DAA and anterolateral approach cohorts (387 &plusmn;&thinsp;163 mL vs. 405&thinsp;&plusmn; 170 mL, P = 0.126); total blood loss rates were also comparable (450 &plusmn; 362 mL vs. 469 &plusmn; 292, P = 0.400). Overall fracture rates did not significantly differ between DAA patients (n = 6, 1.5%) and anterolateral approach patients (n = 4, 1%), nor did surgical site infection rates (n = 1, 0.3% vs. n = 4, 1%, respectively; P = 0.162).&ldquo;The transfusion rate was significantly higher with the anterolateral approach (14.1% vs. 5.8%, p &lt;&thinsp;0.001) at an overall transfusion rate of 9.9%. Although the transfusion rate was higher, the total blood loss was without significant difference (p =&thinsp;0.400),&rdquo; the researchers observed. The anterolateral group also had a much higher complication rate (n = 70, 17.6%) than the DAA group (n = 48, 12.1%; P = 0.018). DAA patients had significantly more dislocations (n = 9, 2.2%) than the anterolateral approach cohort (n = 2, 0.5%; P = 0.032).<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Justin Wilcox, PA-C, discusses <a href="https://twitter.com/hashtag/FAI?src=hash&amp;ref_src=twsrc%5Etfw">#FAI</a> and <a href="https://twitter.com/hashtag/OA?src=hash&amp;ref_src=twsrc%5Etfw">#OA</a> of the hip with two talks to close out our day with the latest on arthroscopy and arthroplasty &ndash; including the direct anterior approach for <a href="https://twitter.com/hashtag/THA?src=hash&amp;ref_src=twsrc%5Etfw">#THA</a>. <a href="https://twitter.com/hashtag/OrthoInTheWest?src=hash&amp;ref_src=twsrc%5Etfw">#OrthoInTheWest</a> <a href="https://t.co/Rqh0Jaesbf">pic.twitter.com/Rqh0Jaesbf</a>
&mdash; PAOS News (@PAOSnews) <a href="https://twitter.com/PAOSnews/status/1096914652867543040?ref_src=twsrc%5Etfw">February 16, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>Two patients in each group sustained intraoperative fractures. In the DAA cohort, one was a femoral fissure Vancouver B and the other was a Vancouver type A fracture; in the anterolateral approach group, one was a minimally dislocated acetabular fracture and the other was a Vancouver B type fracture.&ldquo;The only difference in surgical complications was the higher dislocation rate for DAA, which was higher than in comparable studies,&rdquo; the study authors wrote. &ldquo;Even though preoperative planning was undertaken on digital radiography, the better exposure in the anterolateral approach still makes a difference, which could influence the cup position. Also, the smaller 28&thinsp;mm head was used throughout, whereas it has been shown that the use of a larger head decreases the dislocation rate.&rdquo;The researchers concluded, &ldquo;Direct anterior approach has comparable short-term surgical complications and reduces the transfusion and general complication rate when compared with the Watson Jones anterolateral approach.&rdquo;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Gait analysis after total hip arthroplasty using direct anterior approach versus anterolateral approach: a systematic review and meta-analysis<a href="https://t.co/wnor0fz3R0">https://t.co/wnor0fz3R0</a> <a href="https://t.co/To9etBYDk4">pic.twitter.com/To9etBYDk4</a>
&mdash; Physio Meets Science (@PhysioMeScience) <a href="https://twitter.com/PhysioMeScience/status/1094890406632923138?ref_src=twsrc%5Etfw">February 11, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

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A recent retrospective study published in BMC Musculoskeletal Disorders compared complication rates and bleeding associated with the direct anterior approach (DAA) and ...

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