The Direct Anterior Approach (DAA) as a Standard Approach for Total Hip Arthroplasty (THA) in Coxa Profunda and Protrusio Acetabuli? A Radiographic Analysis of 188 Cases
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Surgical Procedure
2.3. Measurements
2.4. Statistics
3. Results
3.1. Patient Demographics
3.2. Radiographic Outcomes
3.3. Clinical Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Mean (±SD) or Relative Frequency (%) | p-Value (CP Group vs. PA Group) | ||
---|---|---|---|
PA Group | Sex (m/f) | 14.80%/85.20% | 0.55 |
Age, years (a) | 71.52 + 12.46 | 0.01 | |
BMI (kg/m2) | 27.24 ± 4.61 | 0.36 | |
VAS, preoperative | 5.93 ± 2.14 | 0.95 | |
Hip flexion, preoperative (degrees) | 83.61° ± 18.88° | 0.00 | |
Hip abduction, preoperative (degrees) | 13.03° ± 8.33° | 0.00 | |
Hip adduction, preoperative (degrees) | 10.43° ± 7.35° | 0.53 | |
Hip flexion, postoperative (degrees) | 84.70° ± 8.20° | 0.06 | |
Cemented cups | 5 (5.68%) | 0.02 | |
Sex (m/f) | 18.0%/82.0% | 0.55 | |
CP Group | Age, years (a) | 66.96 ± 10.15 | 0.01 |
BMI (kg/m2) | 27.91 ± 5.25 | 0.36 | |
VAS, preoperative | 5.90 ± 2.29 | 0.95 | |
Hip flexion, preoperative (degrees) | 92.22 ± 15.00 | 0.00 | |
Hip abduction, preoperative (degrees) | 18.72° ± 10.95° | 0.00 | |
Hip adduction, preoperative (degrees) | 11.38° ± 8.21° | 0.53 | |
Hip flexion, postoperative (degrees) | 86.76° ± 5.76° | 0.06 | |
Cemented cups | 0 (0.00%) | 0.02 |
Radiographic Parameter | CP Group | PA Group | p-Value (CP vs. PA) |
---|---|---|---|
LCEA (mean ± SD) | 40.41° ± 9.82° | 55.09° ± 9.64° | <0.00 |
Sharp (mean ± SD) | 36.44° ± 5.15° | 34.04° ± 4.81° | <0.00 |
Tönnis (mean ± SD) | 6.16° ± 5.70° | 3.12° ± 5.89° | <0.00 |
Acetabular depth (mean ± SD) | 24.73 mm ± 4.01 mm | 27.92 mm ± 4.67 mm | <0.00 |
ADWR (mean ± SD) | 334.60 ± 43.33 | 388.50 ± 61.22 | <0.00 |
Change of FO (preoperative vs. postoperative) (mean ± SD) | 4.11 mm ± 7.66 mm | 0.71 mm ± 8.21 mm | <0.00 |
FO, preoperative (mean ± SD) | 42.94 mm ± 7.20 mm | 46.22 mm ± 7.57 mm | <0.00 |
FO, postoperative | 47.05 mm ± 5.38 mm | 45.52 mm ± 4.46 mm | 0.03 |
LLD, preoperative (mean ± SD) | 4.49 mm ± 4.24 mm | 7.65 mm ± 6.76 mm | <0.00 |
LLD, postoperative (mean ± SD) | 4.87 mm ± 4.12 mm | 5.41 mm ± 5.00 mm | 0.41 |
AGVD (mean ± SD) | 108.59 mm ± 13.75 mm | 101.91 mm ± 14.36 mm | <0.00 |
GT/ASIS (mean ± SD) | 1.19 ± 0.07 | 1.13 ± 0.07 | <0.00 |
Cup inclination | 36.57° ± 6.57° | 38.13° ± 6.82° | 0.04 |
Preoperative Value | Postoperative Value | p-Value | ||
---|---|---|---|---|
CP Group | FO (mean ± SD) | 42.94 mm ± 7.20 mm | 47.05 mm ± 5.38 mm | <0.00 |
LLD (mean ± SD) | 4.49 mm ± 4.24 mm | 4.87 mm + 4.12 mm | 0.48 | |
PA Group | FO (mean ± SD) | 46.22 mm ± 7.57 mm | 45.52 mm ± 4.46 mm | 0.42 |
LLD (mean ± SD) | 7.65 mm ± 6.76 mm | 5.41 mm ± 5.00 mm | 0.02 |
CP Group | PA Group | p-Value | |
---|---|---|---|
Change of Hb (preoperative vs. postoperative) (mean ± SD) | 2.73 g/dL ± 1.22 g/dL | 2.66 g/dL ± 1.18 g/dL | 0.71 |
Operative time (mean ± SD) | 59.62 min ± 17.78 min | 58.50 min ± 17.81 min | 0.67 |
LOS (days) (mean ± SD) | 8.44 ± 2.09 | 9.11 ± 3.58 | 0.11 |
Complication rates (total number n, percent) | |||
Postoperative anemia | 3 (3.00%) | 2 (2.27%) | 0.54 |
Prolonged wound healing | 4 (4.00%) | 4 (4.54%) | |
Postoperative regional paresthesia | 2 (2.00%) | 1 (1.14%) | |
Respiratory infection Intraoperative fracture (femur or acetabulum) | 2 (2.00%) 1 (0.53%) | 2 (2.27%) 2 (1.06%) |
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Heinz, T.; Vasilev, H.; Anderson, P.M.; Stratos, I.; Jakuscheit, A.; Horas, K.; Holzapfel, B.M.; Rudert, M.; Weißenberger, M. The Direct Anterior Approach (DAA) as a Standard Approach for Total Hip Arthroplasty (THA) in Coxa Profunda and Protrusio Acetabuli? A Radiographic Analysis of 188 Cases. J. Clin. Med. 2023, 12, 3941. https://doi.org/10.3390/jcm12123941
Heinz T, Vasilev H, Anderson PM, Stratos I, Jakuscheit A, Horas K, Holzapfel BM, Rudert M, Weißenberger M. The Direct Anterior Approach (DAA) as a Standard Approach for Total Hip Arthroplasty (THA) in Coxa Profunda and Protrusio Acetabuli? A Radiographic Analysis of 188 Cases. Journal of Clinical Medicine. 2023; 12(12):3941. https://doi.org/10.3390/jcm12123941
Chicago/Turabian StyleHeinz, Tizian, Hristo Vasilev, Philip Mark Anderson, Ioannis Stratos, Axel Jakuscheit, Konstantin Horas, Boris Michael Holzapfel, Maximilian Rudert, and Manuel Weißenberger. 2023. "The Direct Anterior Approach (DAA) as a Standard Approach for Total Hip Arthroplasty (THA) in Coxa Profunda and Protrusio Acetabuli? A Radiographic Analysis of 188 Cases" Journal of Clinical Medicine 12, no. 12: 3941. https://doi.org/10.3390/jcm12123941
APA StyleHeinz, T., Vasilev, H., Anderson, P. M., Stratos, I., Jakuscheit, A., Horas, K., Holzapfel, B. M., Rudert, M., & Weißenberger, M. (2023). The Direct Anterior Approach (DAA) as a Standard Approach for Total Hip Arthroplasty (THA) in Coxa Profunda and Protrusio Acetabuli? A Radiographic Analysis of 188 Cases. Journal of Clinical Medicine, 12(12), 3941. https://doi.org/10.3390/jcm12123941