Innovation & Evolution in Hip Replacement Surgery: Highlights from the Keggi–Rubin Hip Implant Collection at Yale University

Contemporary Hip Surgery in 2021 & Beyond

Inspired by the work of former-Yale-students-turned-surgical-pioneers William Halsted and Harvey Cushing, Yale professors Wayne O. Southwick and Gustaf E. Lindskog, and Nobel Prize winning Yale alumni Dickinson W. Richards and John F. Enders, Dr. Kristaps J. Keggi was driven to explore new possibilities in the world of orthopaedics. His dedication and innovative drive led to his revolutionary development of the direct anterior approach (DAA) for hip reconstruction. Due to the DAA's minimally invasive tissue preservation and associated rapid recovery, the DAA quickly gained support and has become one of the most popular hip replacement techniques used in the United States today. In turn, Dr. Keggi’s life and work served as inspiration for Dr. Lee E. Rubin, who was Dr. Keggi’s “final fellow” and later wrote and published the world’s first comprehensive textbook on the DAA. Today, both Dr. Keggi and Dr. Rubin continue to share their education and surgical experience with generations of Yale Medical students, international visiting surgeon scholars, Yale Orthopaedic Surgery residents, and Yale Arthroplasty Fellows, who collectively represent the future of modern medicine and the ongoing continuum of Yale Orthopaedic Surgery.

Publications

Birth of the Anterior Approach Dr. Keggi’s anterior approach for total hip replacement surgery was first presented as a Scientific Exhibit at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) in Las Vegas, Nevada, in February 1977, and was subsequently published in the journal Clinical Orthopaedics and Related Research in October 1980. (Both the original scientific exhibit handout from 1977 with Keggi's drawings and inscription, and a reprint of the 1980 publication are presented below.)

Drs. Theodore A. Blaine, Lee E. Rubin, Kristaps J. Keggi, and Gary E. Friedlaender at the May 2016 DAA First Edition Book Launch of the “Direct Anterior Approach to Hip Reconstruction” event in the Yale Historical Medical Library.

The Direct Anterior Approach to Hip Reconstruction

https://www.slackbooks.com/the-direct-anterior-approach-to-hip-reconstruction/

In collaboration with North American and European experts in anterior hip reconstructive surgeries, Drs. B. Sonny Bal, Lee E. Rubin, and Kristaps J. Keggi authored, edited, and published the world’s first comprehensive reference text on the technique in 2016. It was redefined as the “Direct Anterior Approach” to best reflect the modern, minimally invasive approach to hip replacement and revision surgeries. The book now serves a landmark reference to help guide surgeons through introductory learning, intermediate technical development, and advanced surgical skills. The second edition of the textbook is forthcoming in 2022 and has been completely updated and reorganized to help lead the next generation of surgeons into a future focused on innovation and improved patient-centered outcomes using the daa.