Complications - OtherThe Direct Anterior Approach is Associated With Early Revision Total Hip Arthroplasty
Section snippets
Patients and Methods
We retrospectively reviewed our institutional database for revision THAs performed by three attending surgeons from January 2005 to December 2015. Eight hundred eighty-seven revision THAs were performed at our institution during this period. Revision THAs performed at our institution in which the primary THA was performed at an outside hospital were identified and included in this report. The other 404 revision THAs (including rerevision THAs, nonreferred patients, conversions of
Results
There were no differences in the demographic data or reasons for revision within the nonanterior or the recent nonanterior groups when considering whether patients underwent an anterolateral or a posterior approach; thus these two surgical approaches were combined within the nonanterior and the recent nonanterior groups. Table 1 shows demographic data of the patients in the direct anterior, nonanterior, and recent nonanterior groups. There were no significant differences among these three
Discussion
Although the number of primary THAs using the direct anterior approach is increasing, few articles have investigated the relationship between surgical approaches and subsequent cause for revision or revision rate 4, 20, 21, 22. The direct anterior approach has been reported to be comparable with other approaches with respect to revision rate [4]. The innovative aspects and complications associated with different surgical approaches, especially the direct anterior approach, are controversial.
Conclusion
The direct anterior surgical approach is associated with a shorter time to referral to our tertiary care practice for revision surgery, when compared with other conventional surgical approaches (posterior and anterolateral) for THA. Furthermore, revision of the femoral component has become relatively more common after the direct anterior surgical approach for cases referred to our practice.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.09.012.