Single-incision anterior approach for total hip arthroplasty on an orthopaedic table

Joel M. Matta, Cambize Shahrdar, Tania Ferguson

Research output: Contribution to journalArticle

313 Citations (Scopus)

Abstract

Dislocation remains the leading early complication of total hip arthroplasty; surgical approach and implant positioning have been recognized as factors influencing total hip arthroplasty stability. We describe a total hip arthroplasty technique done through a single, tissue sparing anterior approach that allows implantation of the femoral and acetabular components without detaching or sectioning any of the muscles and tendons around the hip joint. A series of 437 consecutive, unselected patients who had 494 primary total hip arthroplasty surgeries done through an anterior approach on an orthopaedic table from September 1996 to September 2004 was reviewed. There were 54 hybrid and 442 uncemented hips in the 437 patients (57 bilateral). The average patient age was 64 years. Radiographic analysis showed an average abduction angle of 42°, with 96% in the range of 35° to 50° abduction. The average cup anteversion was 19° with 93% within the target range of 10° to 25°. Postoperative leg length discrepancy averaged 3 ± 2 mm (range, 0-26 mm). Three patients sustained dislocations for an overall dislocation rate of 0.61%, and no patients required revision surgery for recurrent dislocation. There were 17 operative complications, including one deep infection, three wound infections, one transient femoral nerve palsy, three greater trochanter fracture, two femoral shaft fractures four calcar fractures, and three ankle fractures. Operative time averaged 75 minutes (range 40-150 minutes), and the average blood loss was 350 mL (range, 100-1300 mL). The mean hospital stay was 3 days (range, 1-17 days). The anterior approach on the orthopaedic table is a minimally invasive technique applicable to all primary hip patients. This technique allows accurate and reproducible component positioning and leg-length restoration and does not increase the rate of hip dislocation.

Original languageEnglish (US)
Pages (from-to)115-124
Number of pages10
JournalClinical Orthopaedics and Related Research
Issue number441
DOIs
StatePublished - Dec 2005
Externally publishedYes

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Arthroplasty
Orthopedics
Hip
Leg
Ankle Fractures
Femoral Nerve
Hip Dislocation
Femoral Fractures
Hip Joint
Wound Infection
Operative Time
Thigh
Reoperation
Paralysis
Tendons
Femur
Length of Stay
Muscles
Infection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. / Matta, Joel M.; Shahrdar, Cambize; Ferguson, Tania.

In: Clinical Orthopaedics and Related Research, No. 441, 12.2005, p. 115-124.

Research output: Contribution to journalArticle

Matta, Joel M. ; Shahrdar, Cambize ; Ferguson, Tania. / Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. In: Clinical Orthopaedics and Related Research. 2005 ; No. 441. pp. 115-124.
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