Galakatos Gregory R
Gregory R. Galakatos, MD, MSMA member since 1997, is the Missouri Medicine Editorial Board member for Orthopaedic Surgery. He practices at the Mercy Clinic in Orthopaedic Surgery in St. Louis, Missouri.
Mo Med. 2018 Nov-Dec;115(6):537-541.
The direct anterior approach to the hip for total joint arthroplasty has been suggested to have several advantages compared to other popular approaches through its use of a natural intramuscular and intra-nervous interval. Recent emphasis on tissue sparing and minimally invasive outpatient joint replacements has given rise to a significant increase in the utilization of direct anterior total hip arthroplasty (DAA). Proponents of this approach cite improved recovery times, lower pain levels, improved patient satisfaction as well as improved accuracy on both implant placement/alignment and leg length restoration. A number of variations of the procedure have been described and many authors have published their experiences and technical keys to successfully accomplishing this procedure. Described techniques have been performed using specifically designed instruments and specific fracture tables and intra-operative flouroscopy, however this approach may be performed using a regular table with standard arthroplasty tools with alternative patient positioning and without intraoperative imaging. This review summarizes several aspects of the direct anterior approach for total hip arthroplasty and its comparison to other popular approaches to modern hip replacement.
与其他常用的髋关节置换入路相比，髋关节全关节置换的直接前入路因其利用了天然的肌内和神经内间隙而被认为具有多种优势。近期对保留组织和微创门诊关节置换的重视，使得直接前入路全髋关节置换术（DAA）的应用显著增加。该入路的支持者称，其恢复时间缩短、疼痛程度降低、患者满意度提高，并且在植入物放置/对线以及肢体长度恢复方面的准确性也有所提高。已经描述了该手术的多种变体，许多作者发表了他们成功完成此手术的经验和技术要点。所描述的技术是使用专门设计的器械、特定的骨折手术台和术中透视进行的，然而，这种入路也可以使用常规手术台和标准关节置换工具，通过替代的患者体位且无需术中成像来进行。本综述总结了髋关节全关节置换直接前入路的几个方面及其与现代髋关节置换其他常用入路的比较。
