Surgery Indications for DAA THA

In THA, DAA is popularized because surgeons are attracted by the concept of minimally invasive joint replacement. By understanding the various indications and contraindications of surgery, and identifying difficult cases, they can choose more safely and repeatedly the DAA surgery method.

Indications and contraindications

In patients undergoing total hip replacement for the first time, the indications for DAA surgery include pain, functional limitation, joint stiffness, arthritis on imaging, and deformity that failed conservative treatment. Certain previous surgical procedures may be more advantageous to the DAA approach. For example, the anterior approach incision that has been performed around the acetabular osteotomy is beneficial to the choice of DAA THA.

The contraindications of DAA are similar to the contraindications of THA (for example, some severely ill patients have a much greater risk of surgery than expected results, poor patient compliance, local or systemic infections). Obesity (BMI>40kg/m²) is considered to be a relative contraindication because of its higher risk of complications. For example, compared with non-obese patients, the surgical infection rate of morbidly obese patients increased from 1.8% to 9.1%. But on the other hand, DAA THA surgery for obese patients is easier because the fat layer on the front of the thigh is thinner than the fat layer on the side. Even so, the incidence of wound complications in obese patients is higher. This may be due to the thinner dermis and deeper folds in the groin, which can lead to water retention in the incision, misalignment of the incision, and irritation of the incision.

The relative contraindications of DAA THA include severe acetabular deformity, obvious acetabular bone defect, incomplete or fractured acetabular posterior column, internal fixation with acetabular posterior column plate, internals that cannot be removed from the front, or discontinuous pelvis.

The above information is provided by joint prosthesis exporter.