First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece.
JBJS Rev. 2020 Apr;8(4):e0144. doi: 10.2106/JBJS.RVW.19.00144.
In total hip arthroplasty, the advantages of the direct anterior approach (DAA) compared with the direct lateral and posterior approaches include a true intermuscular approach that spares the abductor musculature, protects the soft tissues surrounding the hip, and thus maintains hip joint stability. The disadvantages of the DAA compared with the direct lateral and posterior approaches include a steep learning curve; intraoperative radiation exposure; injury to the nerves, vessels, and muscles; and intraoperative and early postoperative complications including blood loss, wound-healing problems, increased time under anesthesia, proximal femoral fractures and dislocations, complex femoral exposure and bone preparation, and sagittal malalignment of the stem leading to loosening and an increased revision rate. Stem implantation in flexed sagittal position and early femoral-stem failures are more common with the DAA compared with the direct lateral and posterior approaches.
在全髋关节置换术中，直接前入路（DAA）与直接外侧和后入路相比具有以下优势：真正的肌间入路，保留了外展肌，保护髋关节周围的软组织，从而维持髋关节的稳定性。与直接外侧和后入路相比，DAA 的缺点包括陡峭的学习曲线、术中辐射暴露、神经、血管和肌肉损伤以及术中及术后早期并发症，包括失血、伤口愈合问题、麻醉时间延长、股骨近端骨折和脱位、股骨暴露和准备复杂，以及导致松动和翻修率增加的柄矢状位对线不良。与直接外侧和后入路相比，DAA 中更常见的是在屈曲矢状位植入柄和早期股骨柄失败。
