Open Access
CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2024; 65(02): e85-e93
DOI: 10.1055/s-0044-1789007
Artículo de Revisión | Review Article

Surgical Applied Anatomy of the Direct Anterior Approach Total Hip Arthroplasty: Pearls and Pitfalls during the Learning Curve

Article in several languages: español | English
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
,
Ashleigh N. Bush
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
,
Samantha Stanzione
2   Departamento de Cirugía Ortopédica, Pennsylvania Hospital, Filadelfia, Pensilvania, Estados Unidos
,
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
2   Departamento de Cirugía Ortopédica, Pennsylvania Hospital, Filadelfia, Pensilvania, Estados Unidos
› Author Affiliations
Preview

Abstract

The Direct Anterior Approach (DAA) has become an increasingly popular choice among orthopedic surgeons for performing total hip arthroplasty (THA). The DAA provides a less invasive means of accessing the hip joint, which has translated to an earlier recovery of function for many patients following THA. Despite its attractiveness, there continues to be concern in the orthopedic community regarding a learning curve for those not formally trained in the use of the DAA. This so-called learning curve has been associated with a period of increased complications such as component malalignment, increased operative blood loss, need for early revision, among others.

Described here is a reproducible step-by-step approach to performing the DAA with the use of a traction table and C-arm fluoroscopy. It is our belief that with a dedicated period of study, careful attention to detail from patient positioning through capsular releases and bone preparation, and a plan for continued learning that many of the aforementioned complications can be avoided during one's practice transition to the use of the DAA for THA.



Publication History

Received: 04 February 2023

Accepted: 18 June 2024

Article published online:
26 August 2024

© 2024. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil