The Anterior-Based Muscle-Sparing Approach to Total Hip Arthroplasty

Description

The minimally invasive, anterior-based muscle-sparing (ABMS) approach to total hip arthroplasty (THA) is utilized worldwide in select locations as an effective surgical technique. As the name suggests, it is completely muscle-sparing and touts the benefits of anterior-based surgery, including a lower dislocation rate, quicker return to baseline function, and lower narcotic use than many other surgical approaches. However, there is a paucity of collected information on the technique and research associated with this technique. This text serves as a compendium of information for those surgeons interested in utilizing this surgical approach as an all-inclusive reference.  As an alternative anterior-based approach to the direct anterior surgical approach, some surgeons may find the technique an improved alternative for anterior hip-based surgery. Opening chapters present the history of the anterolateral approach and how to transition to the ABMS approach, including surgical anatomy. ABMS technique with the patient positioned in both the lateral and supine positions are then presented, including associated video segments. Considerations such as implant selection, fixation, and other tips and tricks are shared, along with comparisons to other approaches, patient-reported outcomes, complications and revision surgery techniques, and rehabilitation strategies. For  hip surgeons looking to expand their armamentarium of surgical approaches, The Anterior-Based Muscle-Sparing Approach to Total Hip Arthroplasty is a terrific resource. Foreword Preface Acknowledgments Contents Contributors 1: The Idea of “Minimally Invasive Solution” Total Hip Arthroplasty: History and Perspective Behind the Modernization of Surgery Through the Watson-Jones Muscle Interval Introduction History of Hip Approaches The MIS THA Discussion: Stormy Times The “Röttinger Approach” in Comparison Conclusion References 2: Transitioning to the ABMS Approach Introduction Key Steps in Transitioning to the ABMS Approach Conclusion References 3: Anatomy of the ABMS Approach to the Hip Introduction History of the Anterior-Based Muscle-Sparing Approach Surface Anatomy Bony Anatomy Musculature Neurovascular Anatomy Nerves Vessels The Hip Joint: Capsuloligamentous Structures Conclusion References 4: ABMS THA in the Lateral Position Introduction Anesthesia Positioning Incision Conclusion 5: The ABMS Approach to Total Hip Replacement in the Supine Position Introduction Advantages Disadvantages Surgical Technique Conclusion References 6: Outpatient Total Hip Arthroplasty Using an ABMS Approach Introduction Preoperative Day of Surgery Post-Discharge Discharge Medications Rehabilitation Follow-Up Patient Communication Results Conclusion References 7: ABMS Approach for Cementless Total Hip Replacement Introduction Indications and Considerations for Cementless Implants Goals/Strategies of Different Types of Cementless Stems Broach-Only Systems Ream and Broach Systems Contraindications Cerclage Cabling Conclusion References 8: Cemented Total Hip Replacement through the ABMS Approach Introduction Indications for Cementation Acetabular Component Femoral Component Components of Bone Cement Cementing Technique Generations of Cementing Technique Acetabular Cementing Technique Femoral Cementing Technique Benefits of Cementing Decreased Risk of Intraoperative and Postoperative Periprosthetic Fracture Intraoperative Advantages of Cementing Survivorship Risks and Disadvantages of Cementing Increased Operative Time Bone Cement Implantation Syndrome Long-Term Aseptic Loosening Rates May Be Increased When Cementing Revision Difficulties with Cemented Fixation Techniques Unique Considerations When Cementing Through the ABMS Approach The Use of Intraoperative Fluoroscopy Cement Mantle Quality Periprosthetic Fractures and the ABMS Approach Conclusion References 9: Implant Selection in ABMS Surgery Introduction Acetabular Implant Selection Acetabular Preparation Implantation Femoral Implant Selection Femoral Preparation Implantation Special Circumstances: THA for Fracture Experience at Maine Medical Center, Portland, Maine, USA Conclusion References 10: Tips and Tricks to Overcome the Learning Curve of the ABMS Approach to the Hip Introduction Skin Incision Surgical Tips Fascial Incision Surgical Tips Identification of Deep Surgical Interval Surgical Tips Capsular Incision Surgical Tips Femoral Neck Cut Surgical Tips Femoral Head Removal Surgical Tips Femur Mobilization Surgical Tips Acetabular Exposure Surgical Tips Femur Preparation Surgical Tips Tips to Reduce Complications Preventing Femoral Nerve Palsy Preventing Femoral-Sided Complications Preventing Muscle Damage Prevent Dislocation and Leg Length Discrepancies Conclusion References 11: Surgical Navigation in the ABMS Approach to Total Hip Replacement (THR) Introduction Pre-surgical Planning: Principles Authors’ Choices Technique Goals Results: Findings Wasted Time and Morbidity Conclusion References 12: Comparison of the ABMS Approach to Other Surgical Approaches for Total Hip Replacement Introduction Posterolateral Approach Direct Lateral Approach Direct Anterior Approach Anterior-Based Muscle-Sparing Approach (ABMS) via Watson-Jones Interval How Does ABMS Differ from Other Approaches? Conclusion References 13: Periprosthetic Hip Infection Treatment Through the ABMS Approach Introduction DAIR Procedure Via an ABMS Approach One- or Two-Stage Revision Via ABMS Approach Conclusion References 14: How to Avoid Complication in the ABMS Total Hip Replacement Introduction Nerve Injuries Femoral Nerve Injuries Lateral Femoral Cutaneous Nerve Injuries Superior Gluteal Nerve Sciatic Nerve Injury Dislocations Intraoperative Periprosthetic Fractures Conclusion References 15: Revision of the Acetabulum in Total Hip Arthroplasty Introduction Indicating a Patient for Acetabular Revision Through the ABMS Approach Preoperative Patient Evaluation Radiographic Workup Laboratory Workup Indications and Exclusions of the ABMS Approach for Revision THA Classification of Acetabular Bone Deficiency Technical Considerations of Acetabular Revision Through the ABMS Approach Patient Positioning and Surgical Approach Acetabular Exposure Acetabular Component Extraction Revision Acetabular Preparation Revision Acetabular Reconstructive Modalities Polyethylene Liner Exchanges Hemisphere Porous Acetabular Components Large “Jumbo” Cups Trabecular Metal Cups and Augments Cup-Cage and Triflange Reconstruction Unique Considerations of Acetabular Revision Through the ABMS Approach Component Positioning via Intraoperative Fluoroscopy Benefits of the ABMS Relative to the Posterior Approach Conclusion References 16: Femoral Revision via the ABMS Approach Introduction Indications and Contraindications Preoperative Planning Planning Implant Removal Options for Reconstruction Setup and Equipment Technique Approach and Mobilization Stem Removal Removal of a Loose Noncemented Stem Removal of a Cemented Stem Removal of a Well-Fixed Stem ABMS Anterior Osteotomy Osteotomy Technique Methods for Reconstruction Reconstruction with a Cemented Stem Reconstruction with a Noncemented Revision Stem Revision for Periprosthetic Fractures Wound Closure and Postoperative Protocol Conclusion References 17: Total Hip Replacement for Fragility Fractures Using the ABMS Approach in the Older Adult Epidemiology of Femoral Neck Fractures in the Older Adult Incidence and Prevalence Risk Factors Morbidity and Mortality of Femoral Neck Fracture Clinical Presentation Initial History and Physical Exam Radiographic Workup Fracture Classification Surgical Treatment Options for Femoral Neck Fractures Arthroplasty Hemiarthroplasty Total Hip Replacement Closed Reduction Percutaneous Pinning (CRPP) Total Hip Replacement Versus Hemiarthroplasty ABMS Approach Technique for Total Hip Replacement Patient Positioning and Surgical Exposure Acetabular Preparation Femoral Preparation Postoperative Care Implant Considerations Utilizing the ABMS Approach Femoral Component Acetabular Component Femoral Head and Liner Unique Considerations in the Elderly Patient Postoperative Recovery Periprosthetic Fracture Dislocation Conclusion and Author Recommendations References 18: Outcomes of the ABMS THA Introduction Materials and Methods Results Discussion Conclusion References 19: Rehabilitation for THA Using the ABMS Approach Introduction Before Surgery Immediately Postoperatively: Day 0 Early Postoperatively: First 2 Weeks Weeks 3–4 Weeks 5–6 Beyond 6 Weeks Special Considerations Supine Versus Lateral Approaches Capsulectomy Versus Capsule Repair Common Postsurgical Issues Aided by Structured Physical Therapy Overview of the Condition of the Hip Before and After Surgery Gluteal Dysfunction Tensor Fasciae Latae Dysfunction, Coxa Saltans Externa, and Iliotibial Band Syndrome Psoas and Coxa Saltans Internus Lateral Femoral Cutaneous Nerve (LFCN) Irritation Conclusion References Index