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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2024; 65(02): e85-e93
DOI: 10.1055/s-0044-1789007
Artículo de Revisión | Review Article

Anatomía quirúrgica aplicada de la artroplastia total de cadera por abordaje anterior directo: Ventajas y obstáculos durante la curva de aprendizaje

Article in several languages: español | English
James N. Foster 
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
,
Ashleigh N. Bush
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
,
Samantha Stanzione
2   Departamento de Cirugía Ortopédica, Pennsylvania Hospital, Filadelfia, Pensilvania, Estados Unidos
,
Neil P. Sheth 
1   Departamento de Cirugía Ortopédica, Universidad de Pensilvania, Filadelfia, Pensilvania, Estados Unidos
2   Departamento de Cirugía Ortopédica, Pennsylvania Hospital, Filadelfia, Pensilvania, Estados Unidos
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Resumen

El abordaje anterior directo (AAD) se ha convertido en una opción cada vez más popular entre los cirujanos ortopédicos para realizar una artroplastia total de cadera (ATC). El AAD proporciona un medio menos invasivo para acceder a la articulación de la cadera, lo que se traduce en una recuperación más temprana de la función para muchos pacientes después de una ATC. A pesar de su atractivo, sigue habiendo preocupación en la comunidad ortopédica con respecto a una curva de aprendizaje para aquellos que no están capacitados formalmente en el uso del AAD. Esta llamada curva de aprendizaje se ha asociado con un período de aumento de complicaciones como mala alineación de los componentes, aumento de la pérdida de sangre operatoria, necesidad de revisión temprana, entre otras.

Aquí se describe un enfoque reproducible paso a paso para realizar el AAD con el uso de una mesa de tracción y fluoroscopia con arco en C. Creemos que con un período de estudio dedicado, una cuidadosa atención a los detalles, desde la colocación del paciente hasta las liberaciones capsulares y la preparación ósea, y un plan para el aprendizaje continuo, muchas de las complicaciones antes mencionadas se pueden evitar durante la transición de la práctica al uso del AAD para ATC.

Palabras Clave

abordaje anterior directo - AAD - artroplastia total de cadera - ATC - curva de aprendizaje


Publication History

Received: 04 February 2023

Accepted: 18 June 2024

Article published online:
26 August 2024

© 2024. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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