Description : "Drs. Sonny Bal, Lee Rubin, and Kristaps J. Keggi have joined their unique perspectives, along with those of a renowned group of experts in the expanding world of anterior hip reconstructions surgery to create this reference. Dr. Keggi was among the first to recognize and leverage the benefits of the direct anterior approach in hip reconstruction; his 40-plus years of experience as a clinician serve as the foundation for the text. The Direct Anterior Approach to Hip Reconstruction provides a stepwise progression for surgeons to learn how to perform total hip arthroplasty using the direct anterior approach, with detailed chapters and video instruction from an internationally renowned group of expert authors. The chapters are structured to focus on the art of using the direct anterior approach to address a variety of hip pathology, such as femoroaetabular impingment, pediatric operations, revision implant surgery, and others. The unique applications of the direct anterior approach within the fields of pediatrics, trauma, reconstruction, and tumor surgery are highlighted, along with chapters focused on femoroacetabular impingment, hip preservation surgery, and postoperative rehabilitation protocols designed to improve patient outcomes. The final section of the book reviews the evidence-based outcomes related to direct anterior total hip arthroplasty, addresses the evolving implant design concepts specific to this approach, and outlines directions for educating the next generation of residents and fellows who will continue to develop and refine these techniques. Complementing the written text is a website that provides access to educational videos to further enhance the learning experience. "--Provided by publisher.
Description : Introduction: Introduction of new surgical techniques is normal, but seldom monitored in real time. The purpose of this study was to monitor the learning curve when introducing a new surgical technique to a department. We did a prospective evaluation of the learning curve when introducing the minimally invasive direct anterior approach in total hip arthroplasty. We wish to investigate whether there is a learning curve for the direct anterior minimal invasive approach in total hip replacement and what are the early complications to this approach. Methods: The department changed from the direct lateral approach to the minimally invasive direct anterior approach. We monitored the first 522 patients operated using this approach with regards to patient outcome scores and complications 6 months postoperatively. Results: The last 250 patients operated all had significantly better results with regard to patient outcome scores and cup placement. We investigated 100 patients at a time and compared them with the rest of the patient and found the same pattern. This pattern ends when we reach patients somewhere between 200-300. Discussions: We established the learning curve on a departmental level with regards to introduction of the minimal invasive direct anterior approach. We see a steady improvement in scores with regards to patient outcome scores and cup positioning until we reach a steady-state. The learning curve here flattens out. Departments must understand that one should expect early complications and somewhat less than optimal results at first when introducing this new surgical technique.
Description : Abstract : Background: The fluoroscopically assisted direct anterior approach for total hip arthroplasty has gained interest in recent years. One of the perceived advantages is the use of fluoroscopy to aid in the positioning of implants. The purpose of this study was to measure the radiation entrance surface dose to anatomically important areas of both patients and surgeons during direct anterior approach total hip arthroplasty. Methods: Radiation dosimetry badges were placed at the sternal notch and pubic symphysis of 50 patients undergoing direct anterior approach total hip arthroplasty. Badges were also placed on the surgeons outside of their lead aprons at the level of the thyroid. Three fellowship-trained arthroplasty surgeons were involved in the study. Radiation exposure of each badge was measured after each case (surgeon and patient). The cumulative dose was also calculated for the surgeons. To limit surgeon bias during the study, 50 consecutive direct anterior approach total hip arthroplasties that occurred prior to this study were analyzed for total fluoroscopic dose and time and served as a control group. Results: Forty-five subjects met study criteria. In the study group, 1 patient had a detectable thyroid exposure equal to 1 mrem. Seven patients had a detectable radiation entrance surface dose at the pubic symphysis (range, 1 to 7 mrem). No radiation entrance surface dose was detectable in the remaining 44 patients at the sternal notch and 38 patients at the pubic symphysis. Surgeons in the study did not experience a detectable radiation entrance surface dose. The mean fluoroscopic time was 13.72 seconds (range, 6.7 to 28.7 seconds). The mean patient radiation exposure was 178 mrem (range, 54 to 526 mrem). Conclusions: This study demonstrates that during direct anterior approach total hip arthroplasty, the mean patient entrance surface dose at the pubic symphysis and the sternal notch is not detectable in most patients. The mean patient exposure in this study during direct anterior approach total hip arthroplasty was 178 mrem, which is less than a single pelvic radiograph (600 mrem). No surgeon in our study demonstrated a detectable radiation entrance surface dose. Our data suggest that direct anterior approach total hip arthroplasty typically results in a negligible or very low dose of absorbed radiation exposure to the patient and the surgeon. Clinical Relevance: We believe this study to have clinical relevance because both patients and surgeons have evidence that utilization of fluoroscopy during direct anterior total hip replacement places both parties at a relatively low radiation exposure risk.
Description : Offering authoritative, comprehensive coverage of hip surgery, the 2nd Edition of Surgery of the Hip is the definitive guide to hip replacement, other open and arthroscopic surgical procedures, and surgical and nonsurgical management of the hip across the lifespan. Modeled after Insall & Scott Surgery of the Knee, it keeps you fully up to date with the latest research, techniques, tools, and implants, enabling you to offer both adults and children the best possible outcomes. Detailed guidance from expert surgeons assists you with your toughest clinical challenges, including total hip arthroplasty, pediatric hip surgery, trauma, and hip tumor surgery. Discusses new topics such as direct anterior approach for total hip arthroplasty, hip pain in the young adult, and hip preservation surgery. Contains new coverage of minimally invasive procedures, bearing surface selection, management of complications associated with metal and metal bearing surfaces, management of bone loss associated with revision THA, and more. Provides expert, personal advice in "Author’s Preferred Technique" sections. Helps you make optimal use of the latest imaging techniques, surgical procedures, equipment, and implants available. Covers tumors of the hip, hip instability and displacement in infants and young children, traumatic injuries, degenerative joint disorders, and rehabilitation considerations—all from both a basic science and practical clinical perspective.
Description : This friendly and informative book is written by an orthopaedic surgeon specializing in joint replacement and related surgeries, including hip resurfacing and knee arthroscopy. It contains useful information for patients who are considering treatment for hip or knee arthritis and related conditions. Clear and informative chapters explain in plain English what to expect before, during, and after hospitalization, including post-operative exercises and rehabilitation recommendations. Illustrated sections discuss hip and knee surgeries, nonoperative treatment options, surgical approaches, the latest minimally invasive surgery techniques, implant materials and designs (such as ceramic versus metal bearings), and potential complications of surgery. Robert Edward Kennon, MD, is a board certified orthopaedic surgeon practicing in Connecticut who is fellowship trained in adult reconstruction and joint replacement surgery. He trained at Yale and Emory Universities and also has a degree in mechanical engineering.
Description : Abstract : Supplemental Digital Content is available in the text Abstract : Abstract: The direct anterior approach (DAA) to total hip arthroplasty has been promoted as a minimally invasive alternative to the lateral approach, which we sought to verify by systematically reviewing and meta-analyzing the literature comparing clinical, radiographic, and surgical outcomes. Two reviewers independently searched PubMed, OVID, and Web of Science databases for randomized controlled trials (RCTs) and cohort studies comparing the DAA and lateral approach for total hip arthroplasty. Quality of RCTs was assessed using the Jadad scoring system, quality of cohort studies, using the Minors system. Data were extracted and meta-analyzed or qualitatively synthesized for primary outcomes (function, complications, and hospitalization time) and several secondary outcomes. Data were extracted from 12 trials involving 4901 arthroplasty procedures. Meta-analysis showed that DAA was associated with significantly shorter hospitalization than the lateral approach, as well as greater functional rehabilitation and lower perceived pain during the early postoperative period. On the other hand, DAA was associated with longer surgery time. The 2 approaches were associated with similar rates of perioperative surgical complications and transfusions, as well as similar radiographic analysis results. Although DAA may provide shorter hospitalization and faster recovery during the early postoperative period, the available evidence is still insufficient to conclude whether the DAA or lateral approach is superior for total hip arthroplasty. More high-quality studies and subsequent meta-analyses are needed.
Description : This book gives important details of how surgery of the hip joint has evolved around the world. The 22 original chapters are written by experienced consultants, including Drs. John O'Donnell (Melbourne, Australia), Manfred Krieger and Ilan Elias (Frankfurt, Germany), and Nicholas Goddard (London, U.K.). Each chapter is accompanied by excellent, unique figures and references at the end for further reading. The book focuses on several important topics such as the direct anterior approach to the hip joint, setup of a total hip in a day, early experiences in outpatient hip surgery, advances in short-stem total hip arthroplasty (which is becoming increasingly popular in Europe and also worldwide), advances in hemophilic hip joint arthropathy, mesenchymal stem cell treatment of cartilage lesions in the hip over the next few decades, and minimally invasive surgery of the hip joint. This book is a must-have and invaluable reference for any student interested in the progress in hip joint surgery
Description : Step by step guide to hip arthroplasty for orthopaedic surgeons, covering every surgical approach for total hip replacement, from basic procedures to complex techniques. Written by recognised California-based expert Ran Schwarzkopf.
Description : Surgical Treatment of Hip Arthritis: Reconstruction, Replacement, and Revision, by William J. Hozack, MD, is a state-of-the-art reference that addresses the challenging issues you face in this rapidly growing segment of orthopaedic practice. Inside, you’ll find top surgical management strategies for all types of hip arthroplasty presented by leaders from around the world, along with discussions of possible complications, risks and benefits to specific patient populations, and more. Best of all, this resource also offers access to a companion website where you will find the full text of the book, completely searchable. Includes online access to the full text at expertconsult.com for convenient anytime, anywhere reference. Presents state-of-the-art surgical management strategies for hip arthritis—from reconstruction to replacement to revision—by experts worldwide, for comprehensive guidance in one convenient resource. Offers current information on computer-assisted navigation techniques and minimally invasive techniques, to equip you with the latest surgical options. Provides extensive discussions of the management of a full range of complications to help you overcome the challenges you’ll face. Addresses the rationale for and management of revision surgery, given specific patient problems and intraoperative issues, enabling you to make the best informed surgical decisions. Presents more than 600 illustrations, including original line art, radiologic images, and full-color intraoperative photos, that show you exactly what to look for and how to proceed.
Description : The Hip-a volume in the new Arthritis and Arthroplasty series-offers expert guidance on everything from patient selection and pre-operative planning to surgical approaches and techniques. Clear, evidence-based coverage details which technology and methodology used for total Hip arthroplasty (THA), reconstruction or revision is best for each patient. Access discussions of debates on minimally invasive surgery; component material and bearing options; cemented vs. uncemented fixation of the components; and more. Explore alternatives to THA in younger arthritic patients and view expertly narrated video demonstrations of surgical techniques. In addition to providing practical, pragmatic advice in a concise, readable format, this Expert Consult title offers the full text of the book, as well as links to PubMed and periodic content updates, online at expertconsult.com. Access the full text of the book-as well as links to PubMed and periodic content updates on outcome data, component materials, and surgical techniques-online at expertconsult.com. Features procedural videos-narrated by experts-on the included DVD so you can see how to perform particular techniques. Covers periacetabluar osteotomy, neurovascular injury, and other hot topics to keep you abreast of the latest developments in the specialty. Provides evidence-based, clinically focused guidance on patient selection, pre-operative planning, surgical approach and techniques, bearing surfaces and component materials, disease specific options, the management and avoidance of complications, salvage and revision THA strategies, and more. Discusses variations in technique, including cemented vs. cementless fixation, resurfacing or more radical removal of bone, and minimally invasive technique where the exposure is more limited so you can choose which is most effective for each patient. Explores alternatives to THA in younger arthritic patients such as arthroscopy, arthrodesis, osteotomy, and resurfacing. Includes a review page in every chapter for quick reference to pearls and pitfalls for each topic. Presents photographs and interpretive drawings of surgical techniques in full color to bring out intraoperative details as they appear in the operating room. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should online access to the web site be discontinued.