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.
1. Section I. Introduction - p. 1 2. 1. Introduction - p. 3 3. 2. A Definitive History of the Direct Anterior Approach - p. 11 4. 3. Why I Switched to the Direct Anterior Approach: Expert Practice Perspectives From Leading Surgeons - p. 20 5. Section II. Fundamental Direct Anterior Approach Topics - p. 25 6. 4. Surgical Anatomy of the Anterior Hip and Thigh - p. 27 7. 5. Indications for the Direct Anterior Approach - p. 37 8. 6. Direct Anterior Approach for Hip Replacement: The Learning Curve - p. 44 9. 7. Training and Education for the Direct Anterior Approach - p. 49 10. 8. Supine Direct Anterior Approach Technique Without Traction - p. 60 11. 9. Direct Anterior Approach With Modular Table Attachment and Traction Boot - p. 68 12. 10. Direct Anterior Approach With the Mizuho OSI Hana Table - p. 75 13. 11. Direct Anterior Approach in the Lateral Decubitus Position - p. 87 14. 12. The Bikini Incision for the Direct Anterior Approach - p. 93 15. 13. Transitioning From Traction to No Traction With the Direct Anterior Approach - p. 101 16. Section III. Intermediate Direct Anterior Approach Topics - p. 107 17. 14. Role of Fluoroscopic Imaging and Image Guidance - p. 109 18. 15. Managing Obesity in the Direct Anterior Approach - p. 119 19. 16. Robotic-Assisted and Computer Navigation in the Direct Anterior Approach - p. 127 20. 17. Simultaneous Bilateral Direct Anterior Approach - p. 136 21. 18. Avoiding Intraoperative Femur Fractures - p. 144 22. 19. Cementing the Femoral Stem Using the Direct Anterior Approach: Indications and Technique - p. 153 23. 20. Direct Anterior Approach in the Lumbar-Sacral Fusion Patient: EOS Considerations - p. 165 24. 21. Direct Anterior Approach in the Young, High-Demand Patient - p. 175 25. Section IV. Advanced/Revision Surgery Topics - p. 181 26. 22. A Modified Extensile Anterior Approach to the Acetabulum and Anterior Column - p. 183 27. 23. Direct Anterior Approach and Its Distal Extension - p. 192 28. 24. Head and Liner Revision Surgery via the Direct Anterior Approach - p. 197 29. 25. Removal of the Acetabular Component Through the Direct Anterior Approach - p. 203 30. 26. Acetabular Augments, Cage Reconstructions, and Custom Triflanges - p. 209 31. 27. Management of Recurrent Instability via the Direct Anterior Approach - p. 219 32. 28. Hip Arthrodesis Takedown via the Direct Anterior Approach - p. 227 33. 29. Hip Resection Arthroplasty via the Direct Anterior Approach - p. 235 34. 30. Replacing the Dysplastic Hip via the Direct Anterior Approach - p. 241 35. 31. Femoral and Acetabular Osteotomies for the Direct Anterior Approach - p. 248 36. Section V. Application of the Direct Anterior Approach Across Orthopedic Specialties - p. 255 37. 32. Trauma: The Use of the Direct Anterior Approach for Hip Fractures - p. 257 38. 33. Trauma: Acetabular Fractures and Pelvic Discontinuity via the Direct Anterior Approach - p. 268 39. 34. Trauma: Conversion of Prior Acetabular and Femoral Surgery via the Direct Anterior Approach - p. 277 40. 35. Trauma: Hip Hemiarthroplasty via the Direct Anterior Approach for Geriatric Fractures - p. 288 41. 36. Pediatric Orthopaedics: Use of the Direct Anterior Approach in Children and Adolescents - p. 296 42. 37. Hip Preservation: Surgical Techniques via the Hueter Anterior Approach - p. 304 43. 38. Oncology: Tumor Reconstruction of the Hip and Proximal Femur With the Direct Anterior Approach - p. 313 44. 39. Sports Medicine: Mini-Open Direct Anterior Approach, Management of Femoroacetabular Impingement, and Open-Assisted Arthroscopic Management - p. 320 45. 40. Physical Therapy: Updated Guidelines, Protocols, Restrictions, and Telerehabilitation - p. 325 46. Section VI. Outpatient Arthroplasty and Case Efficiency Using the Direct Anterior Approach - p. 337 47. 41. Defining Same-Day Criteria: Knowing When to Change Course - p. 339 48. 42. Multimodal Pain Control, Enhanced Recovery After Surgery, and Rapid Recovery Protocols for the Direct Anterior Approach - p. 348 49. 43. Anesthesia and Regional Blockade Techniques for the Direct Anterior Approach - p. 360 50. 44. Highly Efficient Direct Anterior Approach: The Pathway to Outpatient Hip Replacement - p. 371 51. 45. Operating Room Efficiency for Preparation, Drape, and Room Utilization With the Direct Anterior Approach - p. 380 52. 46. Self-Sufficiency for the Direct Anterior Approach: Using Self-Retaining Retractor Systems - p. 395 53. 47. Designing Outpatient Program and Perioperative Support Resources - p. 403 54. Section VII. Literature and Outcomes - p. 413 55. 48. Update on Direct Anterior Approach Literature in 2020 - p. 415 56. 49. Direct Anterior Approach Outcome Trends From National Databases - p. 424 57. 50. Patient-Reported Outcomes With the Direct Anterior Approach - p. 431 58. 51. Delivering “The Patient Experience” With the Direct Anterior Approach - p. 441 59. 52. Economics, Cost Considerations, and Strategic Program Development Using the Direct Anterior Approach - p. 448 60. Section VIII. Future Directions and Conclusion - p. 459 61. 53. Evolution of Stem Design and Direct Anterior Approach–Specific Technologies - p. 461 62. 54. Direct Anterior Approach Research Trends - p. 469 63. 55. Legal Liability in Adopting New Technologies in Clinical Practice - p. 480 64. 56. The Australian Experience: Evaluating Approach-Based Outcomes - p. 487 65. 57. The Costa Rican Experience: Incorporating the Direct Anterior Approach in Global Surgery Practice - p. 496 66. 58. The Indian Direct Anterior Approach Experience - p. 505 67. 59. Conclusion - p. 515 68. Index - p. 521
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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.
1. Section I. Introduction - p. 1 2. 1. Introduction - p. 3 3. 2. A Definitive History of the Direct Anterior Approach - p. 11 4. 3. Why I Switched to the Direct Anterior Approach: Expert Practice Perspectives From Leading Surgeons - p. 20 5. Section II. Fundamental Direct Anterior Approach Topics - p. 25 6. 4. Surgical Anatomy of the Anterior Hip and Thigh - p. 27 7. 5. Indications for the Direct Anterior Approach - p. 37 8. 6. Direct Anterior Approach for Hip Replacement: The Learning Curve - p. 44 9. 7. Training and Education for the Direct Anterior Approach - p. 49 10. 8. Supine Direct Anterior Approach Technique Without Traction - p. 60 11. 9. Direct Anterior Approach With Modular Table Attachment and Traction Boot - p. 68 12. 10. Direct Anterior Approach With the Mizuho OSI Hana Table - p. 75 13. 11. Direct Anterior Approach in the Lateral Decubitus Position - p. 87 14. 12. The Bikini Incision for the Direct Anterior Approach - p. 93 15. 13. Transitioning From Traction to No Traction With the Direct Anterior Approach - p. 101 16. Section III. Intermediate Direct Anterior Approach Topics - p. 107 17. 14. Role of Fluoroscopic Imaging and Image Guidance - p. 109 18. 15. Managing Obesity in the Direct Anterior Approach - p. 119 19. 16. Robotic-Assisted and Computer Navigation in the Direct Anterior Approach - p. 127 20. 17. Simultaneous Bilateral Direct Anterior Approach - p. 136 21. 18. Avoiding Intraoperative Femur Fractures - p. 144 22. 19. Cementing the Femoral Stem Using the Direct Anterior Approach: Indications and Technique - p. 153 23. 20. Direct Anterior Approach in the Lumbar-Sacral Fusion Patient: EOS Considerations - p. 165 24. 21. Direct Anterior Approach in the Young, High-Demand Patient - p. 175 25. Section IV. Advanced/Revision Surgery Topics - p. 181 26. 22. A Modified Extensile Anterior Approach to the Acetabulum and Anterior Column - p. 183 27. 23. Direct Anterior Approach and Its Distal Extension - p. 192 28. 24. Head and Liner Revision Surgery via the Direct Anterior Approach - p. 197 29. 25. Removal of the Acetabular Component Through the Direct Anterior Approach - p. 203 30. 26. Acetabular Augments, Cage Reconstructions, and Custom Triflanges - p. 209 31. 27. Management of Recurrent Instability via the Direct Anterior Approach - p. 219 32. 28. Hip Arthrodesis Takedown via the Direct Anterior Approach - p. 227 33. 29. Hip Resection Arthroplasty via the Direct Anterior Approach - p. 235 34. 30. Replacing the Dysplastic Hip via the Direct Anterior Approach - p. 241 35. 31. Femoral and Acetabular Osteotomies for the Direct Anterior Approach - p. 248 36. Section V. Application of the Direct Anterior Approach Across Orthopedic Specialties - p. 255 37. 32. Trauma: The Use of the Direct Anterior Approach for Hip Fractures - p. 257 38. 33. Trauma: Acetabular Fractures and Pelvic Discontinuity via the Direct Anterior Approach - p. 268 39. 34. Trauma: Conversion of Prior Acetabular and Femoral Surgery via the Direct Anterior Approach - p. 277 40. 35. Trauma: Hip Hemiarthroplasty via the Direct Anterior Approach for Geriatric Fractures - p. 288 41. 36. Pediatric Orthopaedics: Use of the Direct Anterior Approach in Children and Adolescents - p. 296 42. 37. Hip Preservation: Surgical Techniques via the Hueter Anterior Approach - p. 304 43. 38. Oncology: Tumor Reconstruction of the Hip and Proximal Femur With the Direct Anterior Approach - p. 313 44. 39. Sports Medicine: Mini-Open Direct Anterior Approach, Management of Femoroacetabular Impingement, and Open-Assisted Arthroscopic Management - p. 320 45. 40. Physical Therapy: Updated Guidelines, Protocols, Restrictions, and Telerehabilitation - p. 325 46. Section VI. Outpatient Arthroplasty and Case Efficiency Using the Direct Anterior Approach - p. 337 47. 41. Defining Same-Day Criteria: Knowing When to Change Course - p. 339 48. 42. Multimodal Pain Control, Enhanced Recovery After Surgery, and Rapid Recovery Protocols for the Direct Anterior Approach - p. 348 49. 43. Anesthesia and Regional Blockade Techniques for the Direct Anterior Approach - p. 360 50. 44. Highly Efficient Direct Anterior Approach: The Pathway to Outpatient Hip Replacement - p. 371 51. 45. Operating Room Efficiency for Preparation, Drape, and Room Utilization With the Direct Anterior Approach - p. 380 52. 46. Self-Sufficiency for the Direct Anterior Approach: Using Self-Retaining Retractor Systems - p. 395 53. 47. Designing Outpatient Program and Perioperative Support Resources - p. 403 54. Section VII. Literature and Outcomes - p. 413 55. 48. Update on Direct Anterior Approach Literature in 2020 - p. 415 56. 49. Direct Anterior Approach Outcome Trends From National Databases - p. 424 57. 50. Patient-Reported Outcomes With the Direct Anterior Approach - p. 431 58. 51. Delivering “The Patient Experience” With the Direct Anterior Approach - p. 441 59. 52. Economics, Cost Considerations, and Strategic Program Development Using the Direct Anterior Approach - p. 448 60. Section VIII. Future Directions and Conclusion - p. 459 61. 53. Evolution of Stem Design and Direct Anterior Approach–Specific Technologies - p. 461 62. 54. Direct Anterior Approach Research Trends - p. 469 63. 55. Legal Liability in Adopting New Technologies in Clinical Practice - p. 480 64. 56. The Australian Experience: Evaluating Approach-Based Outcomes - p. 487 65. 57. The Costa Rican Experience: Incorporating the Direct Anterior Approach in Global Surgery Practice - p. 496 66. 58. The Indian Direct Anterior Approach Experience - p. 505 67. 59. Conclusion - p. 515 68. Index - p. 521
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