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Minimally invasive direct anterior approach yields better perioperative outcomes in THR
J Orthopaed Traumatol. 2011. doi: 10.1007/s10195-011-0144-0.
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Perioperative outcomes following a minimally invasive direct anterior approach were better than those found in patients treated with a lateral approach, according to a study from Italian investigators.
The authors performed a retrospective study on 419 consecutive total hip replacement patients with coxarthrosis. These patients were divided into two groups: one group of 198 patients who underwent their surgery via the standard lateral approach, and one group of 221 patients who underwent the same procedure via the minimally invasive direct anterior approach. Length of procedure, intraoperative complications, intraoperative and postoperative blood loss, postoperative pain/nausea/vomiting, length of stay and type of discharge were all assessed as perioperative parameters, the team reported.
The authors found that though the minimally invasive direct anterior approach took longer than the standard lateral approach, the direct anterior approach was still “performed within an acceptable time and with modest blood loss.” The authors also noted direct anterior approach patients experienced less pain and shorter time to discharge. Further, a greater percentage of direct anterior approach patients were discharged directly home.
“The longer time of surgery for the minimally invasive direct anterior approach may be attributed to the learning curve,” the authors wrote. “Further studies are necessary to investigate the advantages of a minimally invasive direct anterior approach in terms of clinical results in the short and long run.”