ArticleJournal of orthopaedics2017
Two-incisions direct anterior approach for THR: Surgical technique and early outcome.
Article in Journal of orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- A systematic review and meta-analysis of iliocapsularis muscle: an important landmark in orthopedic surgery.Surgical and radiologic anatomy : SRA · 2021Pooled it
- Evaluating Return to Sports Following Total Hip Arthoplasty With Custom Stems in Professional and Recreational Table Tennis Players.Orthopaedic journal of sports medicine · 2025Article
- Factors associated with mechanical complications following primary total hip arthroplasty through a modified direct anterior approach using custom stems.International orthopaedics · 2025Article
- High Rates of Satisfaction and Return to Dance in Current or Former Professional Ballet Dancers After Total Hip Arthroplasty With a Muscle-Sparing Direct Anterior Approach Using Custom Femoral Stems.Orthopaedic journal of sports medicine · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn recent times the direct anterior approach for total hip replacement has gained considerable interest among orthopaedic surgeons because of the relative muscle-sparing nature than other surgical approaches. However, critics believe that this approach is associated with steep learning curve and high complication rates, mainly attributed to a more limited exposure to the femur. In order to make femoral access easier and implantation of acetabulum in anatomic plane, we designed a "two incisions anterior approach technique" for total hip replacement. The aim of the present study is to determine safety of this technique with respect to perioperative complications as well as early clinical outcome.
methodsA retrospective review is carried out on a consecutive series of patients who underwent primary total hip replacement by the single surgeon through the two incisions direct anterior approach from 01/2014 to 11/2014. We analysed peri-operative complications and clinical outcome at two years' follow-up.
resultsWe observed 01(0.9%) intra-operative complication; calcar fracture and 01(0.9%) anterior dislocation in first post-operative week. All patients reported improvement of their symptoms. The mean modified oxford hip score was significantly better from 25(11-37), preoperatively to 46.97(33-48) at mean latest follow-up. The mean modified Merle d'Aubigné-Postel score improved to 16.84(12-18) from 9.25 (4-14) preoperatively.
conclusionThe described surgical technique is simple and reproducible technique for easier exposure of femur and insertion of acetabulum in anatomic plane for total hip replacement through direct anterior approach. Easier and better femoral access helps to place implant in anatomical position as well as reduces the risk of femoral fracture associated with inadequate femoral exposure. The added advantage of this technique is, risks of injury to lateral femoral cutaneous nerve can be minimised by careful dissection and isolation of the nerve.
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