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Understanding the Modern Surgeon’s Transition to Anterior Hip Replacement

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Anterior Hip Replacement
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Abstract

The transition from a traditional to the anterior hip approach can occasionally prove to be overwhelming for a surgeon leaving a comfort zone to venture into a new opportunity, regardless of how potentially advantageous it may be. There are technical and skill-based challenges in adopting this as a new technique, as well as external hurdles such as increased reliance on supporting staff coordination. During the process of transition, one proceeds through three stages of leaving the familiar, to a place of ambiguity, to a new beginning. Demystifying the challenges of each phase of transition can make the process safer, smoother, and more enjoyable. Anticipating the sequence of steps of transition also encourages the surgeon to embrace available educational tools and appropriate resources to successfully advance to the next stage. Understanding the transition process to adopting the anterior hip approach may reveal more than just a change of surgical technique, but also a change of philosophy. It can be the difference between remaining content with tradition or seizing new opportunities.

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References

  1. Bridges W. Transitions: making sense of life’s changes. Da Capo Press Inc. Massachusetts; 1980.

    Google Scholar 

  2. Masonis JL, Bourne RB. Surgical approach, abductor function, and total hip arthroplasty dislocation. CORR. 2002;405:46–53.

    Google Scholar 

  3. von Knoch M, Berry DJ, Harmsen WS, Morrey BF. Late dislocation after total hip arthroplasty. J Bone Joint Surg Am. 2002;84-A:1949–53.

    Article  Google Scholar 

  4. Barrett WP, Turner SE, Leopold JP. Prospective randomized study of direct anterior versus posterolateral approach for total hip arthroplasty. J Arthroplast. 2013;28:1634–8.

    Article  Google Scholar 

  5. Abdel M, Berry DJ. Current practice trends in primary hip and knee arthroplasties among members of the American Association of Hip and Knee Surgeons: a long-term update, 2018 AAHKS Annual Meeting Symposium, Volume 34, Issue 7, Supplement, S24–S27, July 01, 2010.

    Google Scholar 

  6. Patel NN, Shah JA, Erens GA. Current trends in clinical practice for the direct anterior approach total hip arthroplasty. J Arthroplast. 2019;34(9):1987–1993.e3.

    Article  Google Scholar 

  7. Menghini RM, Pagnano MW, Trousdale RT, Hozack WJ. Muscle damage during MIS total hip arthroplasty- Smith-Petersen versus posterior approach. Clin Orthop Relat Res. 2006;453:293–8.

    Article  Google Scholar 

  8. Berger RA, Duwelius PJ. The two0-incision minimally invasive total hip arthroplasty: technique and results. Orthop Clin North Am. 2004;35:163–72.

    Article  Google Scholar 

  9. Mardones R, Pagnano MW, Nemanich JP, Trousdale RT. The frank Stinchfield award: muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques. CORR. 2005;441:63–7.

    Article  Google Scholar 

  10. Bremer AK, Kalberer F, Pfirrmann CW, Dora C. Soft-tissue changes in hip abductor muscles and tendons after total hip replacement: comparison between the direct anterior and the transgluteal approaches. JBJS Br. 2011;93:886–9.

    CAS  PubMed  Google Scholar 

  11. Bergin PF, Doppelt JD, Kephart CJ, Benke MT, Graeter JH, Holmes AS, Haleem-Smith H, Tuan RS, Unger AS. Comparison of minimally invasive direct anterior versus posterior total hip arthroplasty based on inflammation and muscle damage markers. JBJS. 2011;93:1392–8.

    Article  Google Scholar 

  12. Nam D, Nunley RM, Clohisy JC, Lombardi AV, Berend KR, Barrack RL. Does patient-reported perception of pain differ based on surgical approach in total hip arthroplasty? JBJS Br. 2019;101:31–6.

    Article  Google Scholar 

  13. Kobayashi H, Homma Y, Baba T, Ochi H, Matsumuto M, Yuasa T, Kaneko K. Surgeons changing the approach for total hip arthroplasty from posterior to direct anterior with fluoroscopy should consider potential excessive cup anteversion and flexion implantation of the stem in their early experience. Int Orthop. 2016;40:1813–9.

    Article  Google Scholar 

  14. Wayne N, Stoewe R. Primary THA: a comparison of the lateral Hardinge approach to an anterior mini-invasive approach. Orthop Rev. 2009;1:27.

    Article  Google Scholar 

  15. Zawadsky MW, Paulus MC, Murray PJ, Johansen MA. Early outcome comparison between the direct anterior approach and the mini-incision posterior approach for primary total hip arthroplasty: 150 consecutive cases. J Arthroplast. 2014;29:1256–60.

    Article  Google Scholar 

  16. Wang Z, Hou J, Hu C, Zhou Y, Gu X, Wang H, Feng W, Cheng Y, Sheng Z, Bao H. A systematic review and meta-analysis of direct anterior approach versus posterior approach in total hip arthroplasty. J Orthop Surg Res. 2018;13:229–40.

    Article  Google Scholar 

  17. Seng BE, Berend KR, Ajluni AF. Anterior-supine minimally invasive total hip arthroplasty: defining the learning curve. Orthop Clin North Am. 2009;40:343–50.

    Article  Google Scholar 

  18. Navarro SM, Frey C, Blackwell T, Voges S, Del Schutte H. Clinical results of direct anterior approach with minimal fluoroscopic exposure optimization techniques. Surg Tech Inter. 2018;33:1–4.

    Google Scholar 

  19. Goosen JM, Kollen BJ, Castalein RM, Kuipers MB, Verheyen CC. Minimally invasive versus classic procedures in total hip arthroplasty. A double-blind randomized controlled trial. CORR. 2011;469:200–8.

    Article  Google Scholar 

  20. Meermans G. The direct anterior approach in total hip arthroplasty- a systematic review of the literature. JBJS Br. 2017;99B:732–40.

    Google Scholar 

  21. Goytia RN, Jones LC, Hungerford MW. Learning curve for the anterior approach total hip arthroplasty. J Surg Orthop Adv. 2012;21:78–83.

    Article  Google Scholar 

  22. Schwartz BE, Sisko ZW, Mayekar EM, Wang OJ, Godron AC. Transitioning to the direct anterior approach in total hip arthroplasty: is it safe in the current health care climate? J Arthroplast. 2016;31:2819–24.

    Article  Google Scholar 

  23. Harford JM, Bellino MJ. The learning curve for the direct anterior approach for total hip arthroplasty: a single surgeon’s first 500 cases. Hip Int. 2017;27:483–8.

    Article  Google Scholar 

  24. De Steiger R, Lorimer M, Solomon M. What is the learning curve for the anterior approach for total hip arthroplasty? CORR. 2015;473:3860–6.

    Article  Google Scholar 

  25. Pogliacomi F, Paraskevopoulos A, Costantino C, Marenghi P, Ceccarelli F. Influence of surgical experience in the learning curve of a new approach in hip replacement: anterior mini-invasive vs standard lateral. Hip Int. 2012;22:555–61.

    Article  Google Scholar 

  26. Berend KR, Lombardi AV, Seng BE, Adams JB. Enhanced early outcomes with the anterior supine intermuscular approach in primary total hip arthroplasty. JBJS. 2009;91:107–20.

    Article  Google Scholar 

  27. Masonis J, Thompson C, Odum S. Safe and accurate: learning the direct anterior total hip arthroplasty. Orthopedics. 2008;31:128–34.

    Article  Google Scholar 

  28. Nistor DV, Caterev S, Bolboaca SD, Cosma D, Lucaciu D, Todor A. Transitioning to the direct anterior approach in total hip arthroplasty. I it a true muscle spearing approach when performed by a low volume hip replacement surgeon? Int Orthop. 2017;41:2245–52.

    Article  Google Scholar 

  29. Ponzio DY, Poulsides LA, Salvatore A, Lee Y, Memtsoudis SG, Alexiades MM. In-hospital morbidity and postoperative revisions after direct anterior versus posterior total hip arthroplasty. J Arthroplast. 2018;33:1421–5.

    Article  Google Scholar 

  30. Post ZD, Orozco F, Diaz-Ledezma C, Hozack WJ, Ong A. Direct anterior approach for total hip arthroplasty: indications, technique, and results. JAAOS. 2014;22:595–603.

    Article  Google Scholar 

  31. Chechik O, Khashan M, Lador R, Salai M, Ama E. Surgical approach and prosthesis fixation in hip arthroplasty worldwide. Arch Orthop Trauma Surg. 2013;133:1595–60.

    Article  Google Scholar 

  32. Mjaaland KE, Svenningsen S, Fensta AM, Havelin LI, Furnes O, Norsletten L. Implant survival after minimally invasive anterior or anterolateral vs conventional posterior or direct lateral approach: an analysis of 21,860 total hip arthroplasties from the Norwegian Arthroplasty Register (2008 to 2013). JBJS. 2017;99:840–7.

    Article  Google Scholar 

  33. Balasubramaniam U, Dowsey M, Ma F, Dunin A, Choong P. Functional and clinical outcomes following anterior hip replacement: a 5-year comparative study versus posterior approach. ANZ J Surg. 2016;86:589–93.

    Article  Google Scholar 

  34. Miller LE, Gondusky JS, Kamath AF, Boettner F, Wright J, Bhattacharyya S. Influence of surgical approach on complication risk in primary total hip arthroplasty. Acta Orthop. 2018;89:289–94.

    Article  Google Scholar 

  35. Maldonado DR, Kyin C, Walker-Santiago R, Rosinsky PJ, Shapira J, Lall AC, Domb BG. Direct anterior approach versus posterior approach in primary total hip replacement: comparison of minimum 2-year outcomes. Hip Intern. 2021;31(2):166–73.

    Google Scholar 

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Correspondence to Alexander P. Sah .

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Sah, A.P. (2022). Understanding the Modern Surgeon’s Transition to Anterior Hip Replacement. In: Matta, J.M., Sah, A.P. (eds) Anterior Hip Replacement. Springer, Cham. https://doi.org/10.1007/978-3-030-91896-5_4

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  • DOI: https://doi.org/10.1007/978-3-030-91896-5_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-91895-8

  • Online ISBN: 978-3-030-91896-5

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