ArticleOrthopaedic surgery2022
Learning Curve of Total Hip Arthroplasty in Direct Anterior Approach without Requiring Corrective Osteotomy for Hip Dysplasia.
Article in Orthopaedic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 13 citations in OpenAlex.
- Learning Curves Associated With Robotic Total Hip Arthroplasty: A Scoping Review.Orthopaedic surgery · 2025Article
- Directly anterior approach for total hip arthroplasty with an acetabular structural bone graft for developmental dysplasia of the hip (Crowe III and IV): a concise 5-year follow-up evaluation.BMC musculoskeletal disorders · 2024Article
- Role of the Conjoined Tendon in Hip Stability Post-Total Hip Arthroplasty: Insights From a Direct Anterior Approach Cadaver Study.Arthroplasty today · 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
- Subtrochanteric Osteotomy in Direct Anterior Approach Total Hip Arthroplasty for Crowe IV Dysplasia-Surgical Technique and Literature Review.Orthopaedic surgery · 2024Review
- Meralgia Paresthetica-An Approach Specific Neurological Complication in Patients Undergoing DAA Total Hip Replacement: Anatomical and Clinical Considerations.Life (Basel, Switzerland) · 2024Article
- Learning curve and short-term clinical outcomes of a new seven-axis robot-assisted total knee arthroplasty system: a propensity score-matched retrospective cohort study.Journal of orthopaedic surgery and research · 2023Article
- The Direct Anterior Approach versus the Posterolateral Approach on the Outcome of Total Hip Arthroplasty: A Retrospective Clinical Study.Orthopaedic surgery · 2022Article
- [Short-term effectiveness of structural bone graft and total hip arthroplasty through direct anterior approach in lateral decubitus position for Crowe typeZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore the learning curve of total hip arthroplasty in direct anterior approach (DA-THA) without requiring corrective osteotomy for patients with unilateral developmental dysplasia of the hip (DDH) through the evaluation of clinical and radiographic results.
methodFrom December 2015 to January 2021, we retrospectively evaluated a surgeon's first 100 patients with unilateral hip dysplasia (Crowe I-III) who underwent DA-THA. All procedures were performed by a fellowship-trained joint surgeon. Cementless hemispheric porous-coated acetabular cups and tapered cementless stems were used in all hips. The radiographic data, including leg length, the height of the center of rotation, femoral head offset, the cup anteversion and inclination angle, were measured. The cumulative sum analysis (CUSUM) and risk-adjusted cumulative sum analysis (RA-CUSUM) were used to determine the learning curve of DA-THA for each patient's operation time. By analyzing the operation time, complication rate, postoperative length of hospitalization and creatine kinase (before surgery and the third day after surgery), estimated blood loss, Harris score, radiographic data were compared between the different stages of the learning curve.
resultsThe mean follow-up time was 35.45 ± 16.82 months. The CUSUM method obtained the maximum turning point of the curve at 43 cases, which divided the learning curve into Learning Period and Mastery Period. The CUSUM learning curve was best modeled as a cubic curve with the equation: CUSUM (min) = 0.001x
conclusionsThe DA-THA is a valuable alternative to achieve satisfactory clinical results for mild-to-moderate DDH patients. Furthermore, accurate analysis of the learning curve of DA-THA for hip dysplasia by the CUSUM method showed that the surgeons need to finish about 43 cases to master the technique.
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