The Direct Anterior Approach to Hip Reconstruction

Dedication
In Memoriam
About the Editors
Foreword
Contributing Authors
Contents
Section I. Introduction
1. Introduction
2. A Definitive History of the Direct Anterior Approach
3. Why I Switched to the Direct Anterior Approach: Expert Practice Perspectives From Leading Surgeons
Section II. Fundamental Direct Anterior Approach Topics
4. Surgical Anatomy of the Anterior Hip and Thigh
5. Indications for the Direct Anterior Approach
6. Direct Anterior Approach for Hip Replacement: The Learning Curve
7. Training and Education for the Direct Anterior Approach
8. Supine Direct Anterior Approach Technique Without Traction
9. Direct Anterior Approach With Modular Table Attachment and Traction Boot
10. Direct Anterior Approach With the Mizuho OSI Hana Table
11. Direct Anterior Approach in the Lateral Decubitus Position
12. The Bikini Incision for the Direct Anterior Approach
13. Transitioning From Traction to No Traction With the Direct Anterior Approach
Section III. Intermediate Direct Anterior Approach Topics
14. Role of Fluoroscopic Imaging and Image Guidance
15. Managing Obesity in the Direct Anterior Approach
16. Robotic-Assisted and Computer Navigation in the Direct Anterior Approach
17. Simultaneous Bilateral Direct Anterior Approach
18. Avoiding Intraoperative Femur Fractures
19. Cementing the Femoral Stem Using the Direct Anterior Approach: Indications and Technique
20. Direct Anterior Approach in the Lumbar-Sacral Fusion Patient: EOS Considerations
21. Direct Anterior Approach in the Young, High-Demand Patient
Section IV. Advanced/Revision Surgery Topics
22. A Modified Extensile Anterior Approach to the Acetabulum and Anterior Column
23. Direct Anterior Approach and Its Distal Extension
24. Head and Liner Revision Surgery via the Direct Anterior Approach
25. Removal of the Acetabular Component Through the Direct Anterior Approach
26. Acetabular Augments, Cage Reconstructions, and Custom Triflanges
27. Management of Recurrent Instability via the Direct Anterior Approach
28. Hip Arthrodesis Takedown via the Direct Anterior Approach
29. Hip Resection Arthroplasty via the Direct Anterior Approach
30. Replacing the Dysplastic Hip via the Direct Anterior Approach
31. Femoral and Acetabular Osteotomies for the Direct Anterior Approach
Section V. Application of the Direct Anterior Approach Across Orthopedic Specialties
32. Trauma: The Use of the Direct Anterior Approach for Hip Fractures
33. Trauma: Acetabular Fractures and Pelvic Discontinuity via the Direct Anterior Approach
34. Trauma: Conversion of Prior Acetabular and Femoral Surgery via the Direct Anterior Approach
35. Trauma: Hip Hemiarthroplasty via the Direct Anterior Approach for Geriatric Fractures
36. Pediatric Orthopaedics: Use of the Direct Anterior Approach in Children and Adolescents
37. Hip Preservation: Surgical Techniques via the Hueter Anterior Approach
38. Oncology: Tumor Reconstruction of the Hip and Proximal Femur With the Direct Anterior Approach
39. Sports Medicine: Mini-Open Direct Anterior Approach, Management of Femoroacetabular Impingement, and Open-Assisted Arthroscopic Management
40. Physical Therapy: Updated Guidelines, Protocols, Restrictions, and Telerehabilitation
Section VI. Outpatient Arthroplasty and Case Efficiency Using the Direct Anterior Approach
41. Defining Same-Day Criteria: Knowing When to Change Course
42. Multimodal Pain Control, Enhanced Recovery After Surgery, and Rapid Recovery Protocols for the Direct Anterior Approach
43. Anesthesia and Regional Blockade Techniques for the Direct Anterior Approach
44. Highly Efficient Direct Anterior Approach: The Pathway to Outpatient Hip Replacement
45. Operating Room Efficiency for Preparation, Drape, and Room Utilization With the Direct Anterior Approach
46. Self-Sufficiency for the Direct Anterior Approach: Using Self-Retaining Retractor Systems
47. Designing Outpatient Program and Perioperative Support Resources
Section VII. Literature and Outcomes
48. Update on Direct Anterior Approach Literature in 2020
49. Direct Anterior Approach Outcome Trends From National Databases
50. Patient-Reported Outcomes With the Direct Anterior Approach
51. Delivering “The Patient Experience” With the Direct Anterior Approach
52. Economics, Cost Considerations, and Strategic Program Development Using the Direct Anterior Approach
Section VIII. Future Directions and Conclusion
53. Evolution of Stem Design and Direct Anterior Approach–Specific Technologies
54. Direct Anterior Approach Research Trends
55. Legal Liability in Adopting New Technologies in Clinical Practice
56. The Australian Experience: Evaluating Approach-Based Outcomes
57. The Costa Rican Experience: Incorporating the Direct Anterior Approach in Global Surgery Practice
58. The Indian Direct Anterior Approach Experience
59. Conclusion
Index

In recent years, the Direct Anterior Approach (DAA) has become a fundamental component of hip reconstruction in modern orthopaedic surgical practice. The Direct Anterior Approach to Hip Reconstruction, 2nd Edition, is a practical, how-to guide that addresses patient anatomy, surgical techniques, and risk avoidance using the anterior approach. A distinguished group of international experts in the field, along with Drs. Lee E. Rubin, B. Sonny Bal, and Joseph T. Moskal, continue the pioneering work of Dr. Kristaps J. Keggi in this thoroughly updated and expanded second edition.

• Covers basic concepts such as anatomy, patient selection, and placement of incisions; intermediate concepts such as the use of imaging and navigation technologies, traction tables, and unique instruments and devices; and advanced concepts such as using the direct anterior approach for bearing and liner exchanges, acetabular revisions, femoral component revisions, and more
• Reflects recent research regarding DAA, with significantly updated and expanded content throughout, newly reorganized and streamlined for ease of use
• Includes take-home points, tips and tricks, and pearls and pitfalls in every chapter, as well as abundant full-color photos
• Addresses key applications of DAA across orthopaedic specialties, outpatient arthroplasty using DAA, and outcomes and future trends
• Provides access to numerous procedural videos online
• Offers orthopaedic residents, fellows, and surgeons a stepwise learning approach to DAA that contributes to improving patient safety, reducing complications, and achieving better surgical outcomes