5th International Conference of Orthopedic Surgeons and Rheumatology

Biography

Biography: Thomas Apostolou

Abstract

Total Hip Arthroplasty (THA) is the second most common joint replacement procedure performed in the United States, aft er primary Total Knee Replacement (TKR). In 2010, more than 300,000 THA procedures were performed. Complications and revision rates, associated with THA, have declined signifi cantly, despite an increasing number of patients at risk for these outcomes. Reasons for residual pain aft er total hip replacement include malalignment of the prosthesis, infection, joint instability, trochanteric bursitis, heterotopic bone formation, and prosthesis loosening. Th e large number of approaches for (THA) had increased signifi cantly the last decades. Transgluteal approach (Hardinge, anterolateral), posterior approach and, recently, anterior approach (AMIS procedure) are the most favorable among the surgeons. Disadvantages of the transgluteal approach are painful limp due to hip abductors damage, pain and stiff ness due to heterotopic ossifi cation, blood loss and prolonged hospitalization. Th e anterior access of the hip was described more than 50 years ago by Robert Judet. Th ese past ten years, several French surgeons, familiar with this technique, have attempted to reduce the size of skin incision, while preserving the muscles in the same manner. Th e benefi ts of AMIS technique are that no muscle or tendon is cut, there is no inter-nervous plane, and is mostly direct approach with small (5-6 cm) incision (real minimal invasive approach). Most comparative studies give a post-op functional advantage to anterior approach with the benefi t of no blood loss, shorter hospital stay and quicker recovery with 2nd post-op day of full weight bearing. Literature validated best functional results with very low dislocation rate for AMIS procedure.