ICJR CASES: Problem Solving with the Direct Anterior Approach

    In a session that Joel M. Matta, MD, labeled an opportunity for problem solving, surgeons experienced in the direct anterior approach for total hip arthroplasty (THA) presented their challenging cases and solicited comments from the panel members on how they would manage the cases.

    Joining Dr. Matta for this session at ICJR’s 10th Annual Direct Anterior Approach Hip Course were Hari P. Bezwada, MD; John M. Keggi, MD; Pasquale Petrera, MD; and Juan C. Suarez, MD

    Here are the cases they presented:

    Dr. Matta first case: A 75-year-old male patient who had previously undergone bilateral posterior approach THA and who is now experiencing recurrent dislocation of his right hip

    Dr. Matta’s second case: A 70-year-old male retired emergency physician who underwent posterior approach THA 1 month prior and who is now concerned about leg length discrepancy and instability of the hip

    RELATED: Direct Anterior Approach THA Through a Bikini Incision

    Dr. Suarez’s first case: A 72-year-old female patient who had undergone a seemingly uncomplicated direct anterior approach THA 6 weeks prior and who now has persistent activity-related anterior thigh pain and external leg rotation

    Dr. Suarez’s second case: A 77-year-old female patient who had undergone a direct anterior approach THA for an insufficiency fracture of the left femoral neck with degenerative changes 2 weeks prior and who now has a postoperative fracture of the greater trochanter

    Dr. Pasquale’s case: A 90-year-old active male patient who fell 10 feet off a ladder while picking apples and as a result, has a comminuted right peritrochanteric fracture with a subtrochanteric extension

    RELATED: New Research on the Direct Anterior Approach

    Dr. Keggi’s first case: An 85-year-old female patient who had initially undergone pinning of a left femoral neck fracture that was converted to a THA and who now has hip pain, shortening of the affected leg, and an inability to ambulate

    Dr. Keggi’s second case: A 75-year-old female patient who had previously undergone left THA and who now has anterior hip pain during ambulating and limitations to her walking distance

    Click the image above to hear what they had to say.

    Faculty Bios

    Joel M. Matta, MD, is from The Steadman Clinic in Vail, Colorado.

    Hari P. Bezwada, MD, is from Princeton Orthopaedic Associates in Princeton, New Jersey.

    John M. Keggi, MD, is from Orthopaedics New England in Middlebury, Connecticut.

    Juan C. Suarez, MD, is from the Miami Orthopedics & Sports Medicine Institute in Coral Gables and Miami, Florida.

    Pasquale Petrera, MD, is from Peninsula Orthopaedic Associates in Salisbury, Maryland.