Minimizing complications in bikini incision direct anterior approach total hip arthroplasty: A single surgeon series of 865 cases

Avinash Alva,Sophia Gogos,Ikram Nizam

doi:10.1186/s40634-020-00318-7

Abstract

PurposeThe purpose of this study was to report all complications during the first consecutive 865 cases of bikini incision direct anterior approach (DAA) total hip arthroplasty (THA) performed by a single surgeon. The secondary aims of the study are to report our clinical outcomes and implant survivorship. We discuss our surgical technique to minimize complication rates during the procedure.MethodsWe undertook a retrospective analysis of our complications, clinical outcomes and implant survivorship of 865 DAA THA’s over a period of 6 years (mean = 3.9yrs from 0.9 to 6.8 years).ResultsThe complication rates identified in this study were low. Medium term survival at minimum 2-year survival and revision as the end point, was 99.53% and 99.84% for the stem and acetabular components respectively. Womac score improved from 49 (range 40–58) preoperatively to 3.5(range 0–8.8) and similarly, HHS scores improved from 53(range 40–56) to 92.5(range 63–100) at final follow-up (mean = 3.9 yrs) when compared to preoperative scores.ConclusionsThese results suggest that bikini incision DAA technique can be safely utilised to perform THA.

Highlights

Rapid functional recovery through minimally invasive techniques for total hip arthroplasty (THA) has received increased attention in recent times [1, 18]
Recent studies indicate that the advantages of direct anterior approach (DAA) include tissue preservation, early functional recovery, decreased post-operative pain, increased accuracy of implant alignment, decreased risk of dislocation, lower risk of revision for instability, smaller leg length discrepancies and improved patient satisfaction at one year following DAA compared to posterior approach [5, 39]
The primary aim of this study was to report all complications during bikini incision DAA THA performed by a single surgeon using a standard operating table

Summary

Introduction

Rapid functional recovery through minimally invasive techniques for THA has received increased attention in recent times [1, 18]. Recent studies indicate that the advantages of DAA include tissue preservation, early functional recovery, decreased post-operative pain, increased accuracy of implant alignment, decreased risk of dislocation, lower risk of revision for instability, smaller leg length discrepancies and improved patient satisfaction at one year following DAA compared to posterior approach [5, 39]. The DAA to the hip using a cosmetic. Alva et al Journal of Experimental Orthopaedics Complication

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