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Direct anterior total hip arthroplasty in supine position using regular OR table : case series and review of complication and reoperation rate.

Direct anterior approach total hip arthroplasty (DAA- THA) has gained popularity in the last decades due to multiple advantages : reduced blood loss, muscle sparing, reduced pain, reduced dislocation rate, shorter hospital stay and faster recovery. However, initial studies have reported an unacceptable high intra-operative complication rate, especially during the learning curve. The complications and reoperations in a consecutive series of 356 DAA- THA's using a supine positioning on a regular OR table, without femoral hyperextension, were analysed retrospectively. Conclusion : This study could not confirm the previously reported high complication rate in DAA-THA. The supine positioning without femoral hyperextension is a safe technique, little susceptible by the surgeon's learning curve.