gms | German Medical Science

Objectives: The aim of the study is to describe our mid-term results using the direct anterior minimally invasive surgery (DAMIS) technique for total hip arthroplasty that allows implantation of the femoral and acetabular components without detaching or sectioning any of the muscles and tendons around the hip joint.

Methods: We investigated all cases of patients that were treated with DAMIS total hip arthroplasty in our clinic during years 2012 - 2018. Patients are positioned on a traction table and an image intensifier is used. The technique includes a 8 cm incision, centered over the tensor fasciae latae and directed laterally toward the lateral aspect of the distal femur. The approach utilizes anterior internervous and intermuscular plane, and has been described as a modified Hueter approach. Patients were allowed for full weight bearing at the 1st postoperative day, and returned to their daily activites 4 weeks after surgery.

Results and conclusion: The study included 818 patients (529 women - 289 men) with a mean age of 63.4 years (range 33-91 years). The mean duration of hospitalization was 3.8 days (range 2-21 days) and the mean follow up was 27 months. The mean duration of surgery was 57 minutes. Mean BMI of patients was 29,3. In 89% of cases, there was intraoperative administration of tranexamic acid. Complications included: Greater trochanter fractures (3,4%), intraoperative periprosthetic fractures (1.1%), dislocations (0,9%), aseptic loosening (0,2%), heterotopic ossification (1,1%), superficial infections (0.9%), sciatic nerve injuries (0.1%) and lateral femoral cutaneous nerve injuries (1.6%). There were no deep infections or major thromboembolic events. The average need for heterologous blood transfusion was 57 ml.