Trial reportInternational orthopaedics2017
Transitioning to the direct anterior approach in total hip arthroplasty. Is it a true muscle sparing approach when performed by a low volume hip replacement surgeon?
Trial report in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Early clinical efficacy and safety of different surgical approaches in total hip arthroplasty: a systematic review and network meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Postoperative Harris Hip Score Versus Harris Hip Score Difference in Hip Replacement: What to Report?Orthopaedic surgery · 2025Pooled it
- Indirect comparisons of traction table versus standard table in total hip arthroplasty through direct anterior approach: a systematic review and frequentist network meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Evaluation of Comparative Efficacy and Safety of Surgical Approaches for Total Hip Arthroplasty: A Systematic Review and Network Meta-analysis.JAMA network open · 2023Pooled it
- A meta-analysis on RCTs of direct anterior and conventional approaches in total hip arthroplasty.Scientific reports · 2021Pooled it
- Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2021Pooled it
- Pooled it
- Using the anterior capsule of the hip joint to protect the tensor fascia lata muscle during direct anterior total hip arthroplasty: a randomized prospective trial.BMC musculoskeletal disorders · 2020Trial
- Heterotopic Ossification Following Total Hip Arthroplasty: A Contemporary Approach-Based Review for Surgeons Utilizing the Direct Anterior Approach.Arthroplasty today · 2026Article
- Lessons from the learning curve of the direct anterior approach in total hip arthroplasty: a systematic review.Musculoskeletal surgery · 2026Review
- Canal fill and radiographic comparison analysis of novel fully hydroxyapatite coated, variable triple-tapered geometry stems: one-year follow-up after direct anterior approach total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2025Article
- Factors associated with mechanical complications following primary total hip arthroplasty through a modified direct anterior approach using custom stems.International orthopaedics · 2025Article
- [Advances in study of surgical approaches and MRI evaluation of total hip arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Which approach of total hip arthroplasty is the best efficacy and least complication?World journal of orthopedics · 2024Article
- Fluoroscopy-guided direct anterior approach total hip arthroplasty provides more accurate component positions in the supine position than in the lateral position.BMC musculoskeletal disorders · 2023Article
- Risk Factors and Predictors for Functional Outcome and Complication Rate in Total Hip Arthroplasty through Minimally Invasive and Conventional Approaches: A Systematic Review and Meta-Regression Analysis of 41 Randomized Controlled Trials.Journal of clinical medicine · 2023Review
- Which patient-specific parameters correlate with operation time for total hip arthroplasty? - A retrospective analysis of the direct anterior approach.International orthopaedics · 2023Article
- The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty.BMC musculoskeletal disorders · 2023Article
- Surgical Approaches in Total Hip Arthroplasty.Journal of orthopaedics and sports medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe conducted this study to establish if the transition from a lateral approach (LA) to the direct anterior approach (DAA) for a low volume hip arthroplasty surgeon during the steep learning curve can be performed maintaining the muscle sparing approach of the DAA without increasing the complication rates.
methodsIn this controlled, prospective, randomized clinical study we investigated 70 patients (35 DAA, 35 LA) with similar demographics that underwent a total hip arthroplasty. Assessment of the two approaches consisted of determining the invasiveness through serum markers for muscle damage (i.e. myoglobin, creatine kinase and lactate dehydrogenase), the operative parameters such as post-operative pain and rescue medication consumption, the component positioning and complication rates.
resultsPost-operative myoglobin levels were higher (p < 0.001) in the LA group (326.42 ± 84.91 ng/mL) as compared to the DAA group (242.80 ± 71.03 ng/mL), but with no differences regarding other biomarkers for muscle damage. Pain levels were overall lower in the DAA group, with a statistical and clinical difference during surgery day (p < 0.001) associated with lower (p < 0.001) rescue medication consumption (median 1 (1; 3) mg morphine vs. 3 (2; 4) mg morphine). Most patients in the LA group reported chronic post-operative pain throughout all three evaluated months, while the majority of patients in the DAA group reported no pain after week six. Component positioning did not differ significantly between groups and neither did complication rates.
conclusionThe DAA can be transitioned from the LA safely, without higher complication rates while maintaining its muscle spearing advantages when performed by a low volume hip arthroplasty surgeon.
Indexed as
Identifiers
28439629What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.