Advantages and learning curve of direct anterior approach in total hip arthroplasty / 中国组织工程研究

ABSTRACT

BACKGROUND: With the trend of minimally invasive and “rapid rehabilitation” in modern surgery, direct anterior approach is preferred by orthopedic surgeon in recent years. OBJECTIVE: To review the direct anterior approach’s history, surgical indications, patients’ selection, surgical methods, common complications, surgery advantages and learning curves, to provide ideas for the rapid rehabilitation of hip arthroplasty. METHODS: PubMed, Wanfang database, and CNKI were retrieved for articles addressing total hip arthroplasty through direct anterior approach published from 1956 to 2020. Key words were minimally invasive, direct anterior approach, total hip arthroplasty, enhanced recovery after surgery, complication, learning curve” in Chinese and English. Finally, 67 articles met the criteria for review. RESULTS AND CONCLUSION: (1) The direct anterior approach is an ideal minimally invasive surgical path because of it walks in the fascia gap and it is a truly neuromuscular interface with no damage to important muscles and nerve blood vessels. (2) Direct anterior approach has advantages of quicker recovery, less postoperative pain, short hospital stay and high patient satisfaction. However, because most doctors in our country have changed their surgical approach to direct anterior approach, direct anterior approach still has shortages, such as long learning curve and high rate of early complications.