ArticleSICOT-J2020
Total hip arthroplasty performed by direct anterior approach - Does experience influence the learning curve?
Article in SICOT-J, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Association of resident training with complication risk in total hip and knee arthroplasty: a systematic review and meta-analysis.Acta orthopaedica · 2025Pooled it
- The learning curve for the direct anterior total hip arthroplasty: a systematic review.International orthopaedics · 2021Pooled it
- Direct anterior approach versus posterolateral approach hemiarthroplasty for treating femoral neck fractures in the elderly: a prospective controlled study.Journal of orthopaedic surgery and research · 2025Trial
- Comparison of Periprosthetic Femoral Bone Remodeling After Total Hip Arthroplasty with Zimmer VerSys Taper Stem or VerSys Midcoat Stem: Long-Term Outcomes.Journal of clinical medicine · 2026Article
- Managing Complications of Total Hip Arthroplasty for Avascular Necrosis Hip Performed Via Anterior Approach.Journal of orthopaedic case reports · 2026Article
- Lessons from the learning curve of the direct anterior approach in total hip arthroplasty: a systematic review.Musculoskeletal surgery · 2026Review
- No Difference in All Cause Revision Following Transition From Cemented to Cementless TKA.The Iowa orthopaedic journal · 2026Article
- Learning Curves Associated With Robotic Total Hip Arthroplasty: A Scoping Review.Orthopaedic surgery · 2025Article
- Comparison of Anterior and Posterior Surgical Approaches in Total Hip Arthroplasty: Effect on Self-Reported and Functional Outcomes.Journal of clinical medicine · 2025Article
- The learning curve of novel implant total knee arthroplasty system in high-volume university center.SICOT-J · 2025Article
- Article
- Article
- Total Hip Arthroplasty Using the Conjoined Tendon-Preserving Posterior Approach: The Modified Posterior Approach with a Minimum of 2-Year Follow-Up.Orthopaedic surgery · 2025Article
- Association of surgeon volume with complications following direct anterior approach (DAA) total hip arthroplasty: a population-based study.Acta orthopaedica · 2024Article
- Learning curve and initial outcomes of a novel percutaneously endoscopic-assisted total hip arthroplasty through mini bikini direct anterior approach: an observational cohort study.Journal of orthopaedic surgery and research · 2024Observational
- Radiographic study of direct anterior approach hip arthroplasty: a 10-15 year follow-up of Chinese patients.Arthroplasty (London, England) · 2024Article
- Anterior Minimally Invasive Approach (AMIS) for Total Hip Arthroplasty: Analysis of the First 1000 Consecutive Patients Operated at a High Volume Center.Journal of clinical medicine · 2024Article
- First 100 total hip arthroplasties performed by a young surgeon using the direct anterior approach: learning curve and complications.Archives of orthopaedic and trauma surgery · 2024Article
- Article
- Surgical Residents´ Results Seem to be Non-Inferior Comparing to More Experienced Surgeons in Femoral Neck Fracture Osteosynthesis.Indian journal of orthopaedics · 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 at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProficiency in the direct anterior approach (DAA) as with many surgical techniques is considered to be challenging. Added to this is the controversy of the benefits of DAA compared to other total hip arthroplasty (THA) approaches. Our study aims to assess the influence of experience on learning curve and clinical results when transitioning from THA via posterior approach in a lateral position to DAA in a supine position.
methodsA consecutive retrospective series of 525 total hip arthroplasty of one senior and six junior surgeons was retrospectively analysed from May 2013 to December 2017. Clinical results were analysed and compared between the two groups and represented as a learning curve. Mean follow up was 36.2 months ± 11.8.
resultsThis study found a significant difference in complications between the senior and junior surgeons for operating time, infection rate, and lateral femoral cutaneous nerve (LFCN) neuropraxia. A trainee's learning curve was an average of 10 DAA procedures before matching the senior surgeon. Of note, the early complications correlated with intraoperative fractures increased with experience in both groups. Operating time for the senior equalised after 70 cases. Dislocation rate and limb length discrepancy were excellent and did not show a learning curve between the two groups.
conclusionDAA is a safe approach to implant a THA. There is a learning curve and initial supervision is recommended for both seniors and trainees. LEVEL OF EVIDENCE: Retrospective, consecutive case series; level IV.
Indexed as
Identifiers
What 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.