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Acetabular Exposure Is Enhanced With Self-Retaining Retractors During Direct Anterior Total Hip Arthroplasty
Orthopedics
|November 25, 2020
Summary
Hands-free retractors offer superior acetabular exposure during direct anterior total hip arthroplasty (THA) compared to manual methods. Higher body mass index negatively impacts exposure for both techniques.
Area of Science:
- Orthopedic Surgery
- Surgical Techniques
- Arthroplasty
Background:
- Direct anterior (DA) total hip arthroplasty (THA) relies on adequate acetabular exposure.
- Current techniques for acetabular exposure include manual and hands-free, self-retaining retractors.
- Quantitative comparisons between these exposure methods are lacking.
Purpose of the Study:
- To quantitatively compare acetabular exposure using hands-free, self-retaining retractors versus a traditional manual technique in DA THA.
- To assess the impact of body mass index (BMI) on acetabular exposure in DA THA.
Main Methods:
- A comparative study involving 65 consecutive DA THA procedures.
- Two digital photographs of acetabular exposure were taken for each hip: one with Charnley/self-retaining retractors and one with a manual technique.
- The percentage of the polyethylene liner exposed was calculated for each photograph.
Main Results:
- The Charnley/self-retaining retractor technique achieved significantly greater acetabular exposure (80.0%) compared to the manual technique (73.1%) (P=.0002).
- Increased body mass index was associated with decreased acetabular exposure for both techniques.
Conclusions:
- Hands-free, self-retaining retractors provide superior acetabular exposure in DA THA compared to manual retraction.
- Surgeons should consider the impact of patient BMI on acetabular exposure when selecting retraction techniques.
