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Anterior THA
In a private communication (09/06) reprinted with permission below, Dr. Joel Matta shares his personal experience with the anterior approach. -NR
I started anterior THA 10 years ago to lessen the chance of dislocation and improve early and late muscle function. The technique is an evolution of a technique originally used in France. The essence of the technique is to be able to replace the hip without cutting muscle, splitting muscle or detaching muscle from the bone. Use of a special table (the OSI PROfx or HANA) greatly facilitates the procedure and makes it applicable to essentially all patients requiring anterior hip replacement. I am a co-designer of these tables with OSI.
PROfx Orthopaedic Table Essentially all prosthesis types are implantable through the approach: cemented, uncemented, ceramic, metal on metal, as well as surface replacement.
My patients are given no post op restrictions regarding motion in the acute phase or long term. I have a few patients who upon really pushing the motion such as ballet exercises have the sensation that the hip is starting to "pop out" (dislocate) and I have told them to not push this but so far none have dislocated with stretching or dance activities.
In over 900 primary anterior hip replacements I have done there have been 3 patients who had a single hip dislocation during the first month after surgery but there have been no instances of recurrent dislocation or need for revision surgery because of dislocation or late dislocation. With anterior hip replacement I think the improvement in early rate of recovery over other techniques is very significant. I think anterior THA is the best regarding motion and muscle function.
I currently consider it "my mission" to teach and advocate this technique.
More information is available on Dr. Matta's web site www.hipandpelvis.com