DIRECT ANTERIOR SURGICAL APPROACH FOR TOTAL HIP ARTHROPLASTY AS AN ALTERNATIVE TO THE DIRECT LATERAL APPROACH

Authors

  • Dmytro Sereda Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872024398-109

Keywords:

Тotal hip replacement, direct anterior, direct lateral, pain, periprosthetic joint infection, rehabilitation

Abstract

The frequency of total hip arthroplasty (THA) is continuously increasing. Currently, efforts are underway to improve the efficiency of this surgery, making the choice of surgical approach a key factor in its success. The direct anterior approach is gaining popularity due to faster patient recovery, but its advantages and disadvantages compared to the direct lateral approach are not yet fully understood. Objective. To compare the outcomes of the direct anterior and direct lateral approaches in primary total hip arthroplasty, as well as to identify ways to improve the results of THA performed using the direct anterior approach. Methods. A literature search was conducted in three bibliographic databases: PubMed, Scopus, and Web of Science. Results. The direct anterior approach has been found to reduce postoperative pain, blood loss, the likelihood of periprosthetic infection, and hospital stay duration. However, there is an increased risk of dislocation and revision surgery. Several randomized controlled trials have been cited, studying issues related to effective pain management, wound healing, prevention of lateral femoral cutaneous nerve injury, blood loss, prosthetic stem design, specific surgical techniques, equipment selection, early mobilization after THA, and the use of modern software for THA planning. Conclusions. The literature review revealed that patients who underwent THA via the direct anterior approach experienced less postoperative pain. The shorter incision associated with this approach also reduces intraoperative blood loss and periprosthetic infection rates. However, the risk of dislocation and subsequent revision surgeries increases, as does the incidence of nerve paralysis due to lateral femoral cutaneous nerve injury.

Author Biography

Dmytro Sereda, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD

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Sereda, D. . (2024). DIRECT ANTERIOR SURGICAL APPROACH FOR TOTAL HIP ARTHROPLASTY AS AN ALTERNATIVE TO THE DIRECT LATERAL APPROACH. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 98–109. https://doi.org/10.15674/0030-59872024398-109

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No. 3 (2024)

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DIGESTS AND REVIEWS

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