Surgeon Benefits

Why should a surgeon consider adopting DAA hip replacement?

Patients that have undergone DAA hip replacement typically experience the following benefits

  • Minimal post-operative pain – with any pain subsiding within hours of surgery

  • Shorter/quicker rehabilitation – usually starts within hours of surgery

  • Shorter hospital stay ('LOS') – many go home the day after surgery

  • Small, single incision scar – typically 6-7 cm

  • Reduction in blood loss during surgery

  • Elimination of limping – minimised muscle and nerve damage

  • Eliminated risk of early dislocation – dislocation is usually associated with posterior hip structure damage – not touched in this procedure

  • Quicker return to 'normal life' – a consequence of all of the above

Minimally Invasive DAA hip surgery is often associated with being 'more difficult' for the surgeon, with a steep learning curve in early cases.

This perception is exacerbated by the reality of (normally) needing several trained scrubbed assistants (or trainee surgeons) or an expensive and cumbersome specialist piece of equipment to help in manipulating and positioning the leg during the procedure. These factors have discouraged surgeons and even led them to abandon the technique after a small number of trials.

Based on direct experience of over 400 successful DAA hip replacements at the Wrexham Maelor Hospital over the last 3 years, we identified a need for a mechanical instrument to assist the surgeon in the necessary leg manipulation required for a successful DAA procedure, with the combined aims of eliminating the resistance of surgeons in adopting the technique and thus allowing more patients to benefit from it. Neither can the economic benefits of dramatic reduction in LOS and other support activities be ignored.

More information about the procedure using FLOTE >>

Our Experience with the Direct Anterior Approach

  • Over 400 cases over 3 years at Wrexham Maelor Hospital

  • 2 cohorts; DAA alone, then DAA with enhanced recovery

  • Mean LOS down from 6.8 to 2.2 days (NJR national average is ~7 days)

  • Unselected patients of ASA 1-4 and BMI up to 41

  • Use of FLOTE leg manipulator allows additional  enhanced recovery protocols

  • 30% of patients go home next day!

The Outcome of this work being the Francis Lamont Orthopaedic Table Extension (FLOTE), developed by 2 brothers - a consultant orthopaedic surgeon and a designer/inventor.

Using FLOTE the surgical team required for successful DAA hip replacement is reduced to Surgeon, Scrub Nurse and (unscrubbed) technician (to operate FLOTE).

How using FLOTE helps with the adoption of DAA

  • Simplified Technique - patient manipulation is greatly reduced and simplified

  • More consistency - intraoperative imaging helps with both preparation and implant placement

  • More reliability - simple device operation = fewer problems

  • More Cases - once 'up the learning curve' procedure time comes down to normal

  • Better Outcomes - stem from above with the additional benefits of enhanced recovery and reduced LOS

  • Enhanced Reputation - your patients will love it

  • Improved Skills - you can concentrate on the 'surgery' and worry less about the limb manipulation

  • More Cases - with fewer resources

More information about the procedure using FLOTE >>