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General Orthopaedics

Learning Curve of DAA-THA: Analysis of the First 100 Cases

International Society for Technology in Arthroplasty (ISTA)



Abstract

Background:

The direct anterior approach (DAA) is one of the muscle sparing approaches in total hip arthroplasty (THA). The advantages of the DAA-THA include low dislocation rate, quick recovery with less pain, and accurate implantation. However, complications related to the learning curve have been reported. The aim of this study was to analyze the first 100 cases of DAA-THA performed by 2 surgeons.

Methods:

The records of first 100 consecutive primary DAA-THAs performed by 2 orthopedic surgeons who have np experience of DAA-THA previously were retrospectively reviewed. All operations were performed using DAA in the supine position without the special traction table. The surgical result, the early clinical results, complications, and accuracy of prosthesis placement were investigated.

Results:

The mean intraoperative blood loss was 424 ± 216 m. The mean operative time was 55.4 ± 17.5 minutes. One-hundred and ninety-one cups (96%) were placed within the Lewinnek's safe zone. The overall complication rate was 6% (12 hips), including 5 proximal femoral fracture, 3 stem subsidence, 2 temporal femoral nerve palsy, and 2 cup migration. No revision surgery was required, No postoperative dislocation occurred.

Conclusion:

We analyzed the first 100 cases of DAA-THA performed by 2 orthopedic surgeons. We concluded that with appropriate training this procedure can be performed safely and effectively without increasing the risk of complications.


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