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Original research
Pneumatic femoral broaching in direct anterior approach hip arthroplasty
  1. Ikram Nizam1,
  2. Ashish Vinodkumar Batra2,
  3. Sophia Gogos3,
  4. Avinash Alva1
  1. 1 Ozorthopaedics, Orthopaedics, Malvern, Victoria, Australia
  2. 2 Orthopaedics, Mulgrave Private Hospital, Mulgrave, Victoria, Australia
  3. 3 Alfred Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Ikram Nizam, Centre for Adult joint Reconstruction, Ozorthopaedics, Malvern, VIC 3144, Australia; ikramnizam{at}


Aim The aim of this study is to report the safety and efficacy of the Woodpecker pneumatic broaching system in direct anterior hip arthroplasty.

Methods 649 primary elective anterior bikini total hip arthroplasties (THA) using Woodpecker broaching over a 5-year period were included. Patients undergoing a THA through a different surgical approach, revision THA or arthroplasties for hip fractures were excluded (n=219). Preoperative and postoperative Harris Hip Scores (HHS) and postoperative radiographs were analysed to identify femoral fractures and femoral component positioning. Complications and component survivorship until most recent follow-up were analysed.

Results The average time taken for femoral preparation using Woodpecker broaching system was 2.8 min (1.4–7.5 min) in both cemented and uncemented THAs. Radiographic analysis revealed 67.3% of the stems were placed in 0°–1.82° of varus and 32.7% placed in 0°–1.4° of valgus. Average HHS were 24.4 preoperatively, with significant improvements at 6 weeks (80.95), 6 months (91.91) and 12 months (94.18) of follow-up. Complications not directly attributed to Woodpecker broaching included three intraoperative femoral fractures (0.4%), three periprosthetic postoperative fractures (0.3%), two cases of stem subsidence (0.3%) and two wound infections (0.3%). At the most recent follow-up, the survivorship of the acetabular component was 99.7% and the femoral component was 99.1%, with mean follow-up of 2.9 years (0.5–5 years).

Conclusion The pneumatic Woodpecker device is a safe and effective alternative tool in minimally invasive direct anterior hip replacement surgery for femoral broaching performed on a standard table.

  • surgical procedures
  • operative
  • patient care
  • orthopaedics

Data availability statement

Data are available upon reasonable request. Details of all surgeries are maintained in hospitals and clinics which may be available if requested.

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Data availability statement

Data are available upon reasonable request. Details of all surgeries are maintained in hospitals and clinics which may be available if requested.

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  • Contributors IN: study design, lead surgeon, data collection, editing. AVB: drafting the paper, revised the paper, editing, data analysis. SG: drafting the paper, revised the paper, editing. AA: drafting the paper, revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests IN receives fee for surgical education.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.