Moskal JT, Capps SG, Scanelli JA. Anterior muscle sparing approach for total hip arthroplasty. World J Orthop 2013; 4(1): 12-18 [PMID: 23362470 DOI: 10.5312/wjo.v4.i1.12]
Corresponding Author of This Article
Joseph T Moskal, MD, Virginia Tech Carilion School of Medicine, 3 Riverside Circle, Roanoke, VA 24016, United States. jtmoskal@carilionclinic.org
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World J Orthop. Jan 18, 2013; 4(1): 12-18 Published online Jan 18, 2013. doi: 10.5312/wjo.v4.i1.12
Anterior muscle sparing approach for total hip arthroplasty
Joseph T Moskal, Susan G Capps, John A Scanelli
Joseph T Moskal, Virginia Tech Carilion School of Medicine, 3 Riverside Circle, Roanoke, WV 24016, United States
Susan G Capps, Bensol-Biologic Engineering Solutions, Warsaw, IN 46582, United States
John A Scanelli, Department of Orthopedic Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, United States
Author contributions: Moskal JT contributed to background research, formulation of manuscript, revision of manuscript, selecting of images, oversight/guidance, final approval of manuscript; Capps SG contributed to background research, formulation of manuscript, revision of manuscript, procurement and management of images, final approval of manuscript; Scanelli JA contributed to background research, formulation of manuscript, revision of manuscript, procurement and management of images, final approval of manuscript.
Correspondence to: Joseph T Moskal, MD, Virginia Tech Carilion School of Medicine, 3 Riverside Circle, Roanoke, VA 24016, United States. jtmoskal@carilionclinic.org
Telephone: +1-540-5261472 Fax: +1-540-9838211
Received: January 30, 2012 Revised: November 28, 2012 Accepted: December 23, 2012 Published online: January 18, 2013
Abstract
The purpose of this review is to examine the validity of positive claims regarding the direct anterior approach (DAA) with a fracture table for total hip arthroplasty. Recent literature regarding the DAA was searched and specific claims investigated including improved early outcomes, speed of recovery, component placement, dislocation rates, and complication rates. Recent literature is positive regarding the effects of total hip arthroplasty with the anterior approach. While the data is not definitive at present, patients receiving the anterior approach for total hip arthroplasty tend to recover more quickly and have improved early outcomes. Component placement with the anterior approach is more often in the “safe zone” than with other approaches. Dislocation rates tend to be less than 1% with the anterior approach. Complication rates vary widely in the published literature. A possible explanation is that the variance is due to surgeon and institutional experience with the anterior approach procedure. Concerns remain regarding the “learning curve” for both surgeons and institutions. In conclusion, it is not a matter of should this approach be used, but how should it be implemented.
