Dissemination of Total hip Arthroplasty through the direct anterior approach has, depending upon one's experience and perspective, benefitted from or been plagued by aggressive marketing. Although first developed over 60 years ago it was all but unknown until the past decade. This study exams one community surgeon's experience and thus sheds light on whether the ATHA is a viable operation for all orthopaedic surgeons. 332 hips having a THA through the direct anterior approach were prospectively studied. Side and sex distribution were approximately equal; primary OA was by far the most common diagnosis. 4 hips were converted from a previous operation for fracture. No hips were excluded; all hips were replaced through the direct anterior approach. All hips had the same HA coated, cementless triple-taper stem; a variety of cups were used. 92% of the bearings were ceramic on poly including 22% “dual mobility” design; 88% of the heads were 28 or 32 mm. A special orthopaedic table and intraoperative c-arm were used universally. Charnley Merle D'Aubigne, Harris, and WOMAC scores were obtained before surgery and annually thereafter. Anti-embolic prophylaxis was with intraop bilateral thigh high sequential pumps, early mobilization and aspirin for most. Those patients deemed at risk received lovenox, and those already on Coumadin continued – with bridging lovenox.Introduction
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