Anterior Approach

As an industry leader in Anterior Approach, DePuy Synthes launches ANTERIOR ADVANTAGE™, a differentiated solution for Anterior Approach, inclusive of DePuy Synthes primary and revision hip implant products, instrumentation, enabling technologies, and world-class professional education designed to help decrease the learning curve and increase OR efficiency and surgical reproducibility with the goal of better patient outcomes. We continue to work closely with thought leaders around the globe to deliver world class Anterior Approach training and education, products, and enabling technologies to surgeons, patients and hospital teams worldwide.

DePuy Synthes has had a long-standing collaboration with Dr. Joel Matta, who has championed and evolved the Anterior Approach in the U.S. and expanding the adoption outside the US to what is now known as the ANTERIOR ADVANTAGE™ MATTA METHOD™, a defined ANTERIOR ADVANTAGE™ technique, which specifies the use of Hana™, or other orthopaedic table and intra-operative imaging for cup placement.

DePuy Synthes works with internationally recognized thought leaders and design surgeons who have helped create and support a strong primary and revision hip implant portfolio. The CORAIL® Hip System and PINNACLE® Acetabular Cup System continue to demonstrate positive patient outcomes and survivorship year after year.1-4 See the Products tab below for a list of DePuy Synthes products compatible with ANTERIOR ADVANTAGE™ and ANTERIOR ADVANTAGE™ MATTA METHOD™.


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Dr. Matta is an orthopaedic surgeon specializing in Hip Disorders related to Preservation, Replacement and Fractures at The Steadman Clinic in Vail, CO, the co-founder and chairman of the Anterior Hip Foundation (AHF, www.anteriorhipfoundation.com), and the author of over 100 publications and videos on hip replacement and pelvic surgery.


Products for this Procedure

Features & Benefits

  Features Benefits
The anterior approach can provide improved outcomes and increased patient satisfaction. Reproducible Technique DePuy Synthes has had a long-standing collaboration with Dr. Joel Matta, who has championed and evolved the Anterior Approach in the U.S. to what is now known as the ANTERIOR ADVANTAGE™ MATTA METHOD™, a defined, reproducible ANTERIOR ADVANTAGE™ technique.
THA courses offered which include peer-to-peer and hands-on training. World-Class Education Opportunities DePuy Synthes Companies offer ANTERIOR ADVANTAGE™ MATTA METHOD™ specific THA courses including peer-to-peer training with hands-on cadaveric labs, didactic lectures, and interactive discussions. Additional support materials are available to assist participants throughout the entire learning process including a standardized surgical technique, clinical papers, filmed surgeries, OR visitations, and field specialist support.
DePuy Synthes Companies has 20 years of anterior approach surgical experience. Potential for Improved Outcomes and Increased Patient Satisfaction ANTERIOR ADVANTAGE™ uses a muscle sparing surgical technique and is associated with less pain5, 6, 8, faster recovery5, 11, 12, and reduced length of stay1, 5, 9 vs. traditional approaches. ANTERIOR ADVANTAGE™ also shows cost reduction7, 9 vs. traditional approaches.
The anterior approach can provide cost efficiencies with lower dislocation rates and shorter hospital stays. Reducing Cost of Care THA with the ANTERIOR ADVANTAGE™ MATTA METHOD™ resulted in $6,200 cost savings per patient ($17,763 with ANTERIOR ADVANTAGE MATTA METHOD vs. $23,969 compared to the cohort)10

 

References:

  1. Jacquot L, Bonnin MP, Machenaud A, Choteau J, Saffarini M, Vidalain JP. Clinical and Radiographic Outcomes at 25-30 Years of a Hip Stem Fully Coated With Hydroxyapatite. J Arthroplasty. 2018 Feb;33(2):482-490.
  2. NJRNational Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 15th Annual Report, 2018. Table 3.9. Available from www.njrreports.org.uk
  3. TSM Report, PINNACLE WW implantations YTD, 2001 - 2017.
  4. Miller LE, Kamath AT, Boettner F, Bhattacharyya S. In-hospital outcomes with anterior versus posterior approaches in THA: meta-analysis of randomized controlled trials. Journal of Pain Research. 2018: 11 1327-1334.
  5. Barrett WP, et al. “Prospective Randomized Study of Direct Anterior vs Postero-Lateral Approach for Total Hip Arthroplasty.” The Journal of Arthroplasty 2013; (28): 1634-1638.
  6. Zawadsky MW, et al. “Early Outcome Comparison Between the Direct Anterior Approach and the Mini-Incision Posterior Approach for Primary Total Hip Arthroplasty: 150 Consecutive Cases.” The Journal of Arthroplasty 2014; (29): 1256-1260.
  7. Petis SM, et al. “In Hospital Cost Analysis of THA: Does Surgical Approach Matter?” The Journal of Arthroplasty 2016; (31)” 53-58.
  8. Bourne MH, et al. “A comparison between direct anterior surgery of the hip (DASH) and the anterolateral (AL) surgical approach to THA: Postoperative outcomes.” 2010 AAOS New Orleans, LA, Poster #014
  9. Kamath A, Chitnis A, Holy C, et al. Medical resource utilization and costs for total hip arthroplasty: benchmarking an anterior approach technique in the Medicare population. J Med Econ. 2017; 1-7.
  10. Miller LE, Martinson MS, Gondusky JS, Kamath AF, Boettner F, Bhattacharyya S. Ninety-day postoperative cost in primary total hip arthroplasty: An economic model comparing surgical approaches. ClinicoEconomics and Outcomes Research. 2019; X-X.
  11. Miller LE, Gondusky JS, Kamath AT, Boettner F, Wright J, Bhattacharyya S. Influence of Surgical Approach on Long-Term Complication Risk in Primary Total Hip Arthroplasty: Systematic Review and Meta-analysis. Acta Orthopaedica. 2018; 89: 1-7.
  12. Boettner F, Zingg M, Emara A, et al. The Accuracy of Acetabular Component Positioning Using a Novel Method to Determine Anteversion. JoA. 2017; (32): 1180-1185.
  13. Rathod PA, et al. “Does fluoroscopy with anterior hip arthroplasty decrease acetabular cup variability compared with a nonguided posterior approach?” Clin Orthop Relat Res 2012; (472): 1877-1885.

Evidence

ANTERIOR ADVANTAGE™ MATTA METHOD™ uses a muscle sparing surgical technique and is associated with less pain5, 6, 8, faster recovery5, 8, 9, and reduced length of stay5, 7, 9 vs. traditional approaches. Reproducible results mean you can help your patients return to daily living quicker. ANTERIOR ADVANTAGE™ MATTA METHOD™ also shows cost reduction7, 9, 10 vs. traditional approaches.

 


LESS PAIN Than Those Treated with Traditional Approaches FASTER RECOVERY
When compared to posterior approach patients, ANTERIOR ADVANTAGE™ MATTA METHOD™ patients have reported less pain at day one5 and less pain at week six post-operatively compared to antero-lateral patients.8 ANTERIOR ADVANTAGE™ MATTA METHOD™ subjects walked farther post-operatively, and on days 2 and 3, compared to posterior approach patients.5
LESS NARCOTIC USE REDUCED LENGTH OF STAY
Compared to posterior approach patients, ANTERIOR ADVANTAGE™ MATTA METHOD™ patients consume less narcotics in the first three days after surgery14 and are less likely to be using narcotics for pain control at 2 and 6 weeks follow-up.6 ANTERIOR ADVANTAGE™ MATTA METHOD™ patients were discharged almost one day sooner than patients with posterior approach (2.28 days vs 3.02 days, p=0.0028).5
REDUCED RISK OF DISLOCATION TARGET COMPONENT POSITIONING

ANTERIOR ADVANTAGE™ MATTA METHOD™ is a defined solution for Anterior Approach, a muscle sparing technique. The Anterior Approach is associated with lower risk of dislocation compared to the posterior approach. 11,15

ANTERIOR ADVANTAGE™ MATTA METHOD™ is a defined solution for Anterior Approach, which specifies the use of fluoroscopy for intra-operative images. Component positioning using intra-operative image check with the anterior approach is more accurate than positioning with the posterior approach without intra-operative check.12,13
REDUCING COST OF CARE  
THA with the ANTERIOR ADVANTAGE™ MATTA METHOD™ resulted in $6,200 cost savings per patient ($17,763 with ANTERIOR ADVANTAGE MATTA METHOD vs. $23,969 compared to the cohort)10  

 

References:

  1. Jacquot L, Bonnin MP, Machenaud A, Choteau J, Saffarini M, Vidalain JP. Clinical and Radiographic Outcomes at 25-30 Years of a Hip Stem Fully Coated With Hydroxyapatite. J Arthroplasty. 2018 Feb;33(2):482-490.
  2. NJRNational Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 15th Annual Report, 2018. Table 3.9. Available from www.njrreports.org.uk
  3. TSM Report, PINNACLE WW implantations YTD, 2001 - 2017.
  4. Miller LE, Kamath AT, Boettner F, Bhattacharyya S. In-hospital outcomes with anterior versus posterior approaches in THA: meta-analysis of randomized controlled trials. Journal of Pain Research. 2018: 11 1327-1334.
  5. Barrett WP, et al. “Prospective Randomized Study of Direct Anterior vs Postero-Lateral Approach for Total Hip Arthroplasty.” The Journal of Arthroplasty 2013; (28): 1634-1638.
  6. Zawadsky MW, et al. “Early Outcome Comparison Between the Direct Anterior Approach and the Mini-Incision Posterior Approach for Primary Total Hip Arthroplasty: 150 Consecutive Cases.” The Journal of Arthroplasty 2014; (29): 1256-1260.
  7. Petis SM, et al. “In Hospital Cost Analysis of THA: Does Surgical Approach Matter?” The Journal of Arthroplasty 2016; (31)” 53-58.
  8. Bourne MH, et al. “A comparison between direct anterior surgery of the hip (DASH) and the anterolateral (AL) surgical approach to THA: Postoperative outcomes.” 2010 AAOS New Orleans, LA, Poster #014
  9. Kamath A, Chitnis A, Holy C, et al. Medical resource utilization and costs for total hip arthroplasty: benchmarking an anterior approach technique in the Medicare population. J Med Econ. 2017; 1-7.
  10. Miller LE, Martinson MS, Gondusky JS, Kamath AF, Boettner F, Bhattacharyya S. Ninety-day postoperative cost in primary total hip arthroplasty: An economic model comparing surgical approaches. ClinicoEconomics and Outcomes Research. 2019; X-X.
  11. Miller LE, Gondusky JS, Kamath AT, Boettner F, Wright J, Bhattacharyya S. Influence of Surgical Approach on Long-Term Complication Risk in Primary Total Hip Arthroplasty: Systematic Review and Meta-analysis. Acta Orthopaedica. 2018; 89: 1-7.
  12. Boettner F, Zingg M, Emara A, et al. The Accuracy of Acetabular Component Positioning Using a Novel Method to Determine Anteversion. JoA. 2017; (32): 1180-1185.
  13. Rathod PA, et al. “Does fluoroscopy with anterior hip arthroplasty decrease acetabular cup variability compared with a nonguided posterior approach?” Clin Orthop Relat Res 2012; (472): 1877-1885.
  14. Schweppe et al. Does Surgical Approach in Total Hip Arthroplasty Affect Rehabilitation, Discharge Disposition, and Readmission Rate? Surgical Technology International XXIII. 2013. Orthopedic Surgery, 219-227.
  15. Higgins BT, et al. 2018. JOA. “Anterior vs. posterior approach for THA, a systematic review and meta-analysis.” The Journal of Arthroplasty 2015; (30): 419-434
107575-190213 DSUS 3/2019

Please refer to the package insert for a complete list of indications, contraindications, precautions and warnings.
For further information on DePuy Synthes products, please contact your local DePuy Synthes representative.