Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients
Abstract Background The direct anterior approach (DAA) has gained popularity in total hip arthroplasty (THA) over the past decade. A large number of studies have compared the DAA to other approaches with inclusion of a learning curve phase. The aim of this study was to compare the complication rate...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-02-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2463-x |
| _version_ | 1818335913935110144 |
|---|---|
| author | Antonio Klasan Thomas Neri Ludwig Oberkircher Dominik Malcherczyk Thomas Jan Heyse Christopher Bliemel |
| author_facet | Antonio Klasan Thomas Neri Ludwig Oberkircher Dominik Malcherczyk Thomas Jan Heyse Christopher Bliemel |
| author_sort | Antonio Klasan |
| collection | DOAJ |
| description | Abstract Background The direct anterior approach (DAA) has gained popularity in total hip arthroplasty (THA) over the past decade. A large number of studies have compared the DAA to other approaches with inclusion of a learning curve phase. The aim of this study was to compare the complication rate and bleeding between the DAA and the anterolateral approach after the learning curve phase. Methods For this retrospective, single-institutional study, propensity score matching was performed, from an initial cohort of 1408 patients receiving an elective THA. Two matching groups were created, comprising of 396 patients each. After matching, both groups were similar in age, gender, body mass index, anesthesiologist’s score and surgeon’s experience. Results Average age in the matched groups was 68.7 ± 10.3 years. The total blood loss was similar in both groups, 450 vs 469 mL (p = 0.400), whereas the transfusion rate (14.1 vs 5.8%, p < 0.001) and the overall complication rate (17.6 vs 12.1%, p = 0.018) were lower in the DAA group. The overall fracture rate was comparable, 1.5 vs 1% (p = 0.376), as well as the early infection rate, 0.3 vs 1% (p = 0.162). The dislocation rate was significantly increased in the DAA group, 2.2 vs 0.5% (p = 0.032). Conclusions The direct anterior approach has comparable short-term surgical complications with reduced transfusion and general complication rates. Level of evidence Level III retrospective study. |
| first_indexed | 2024-12-13T14:30:59Z |
| format | Article |
| id | doaj.art-bcb58e4e711c42029a344d8d9d92c266 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T14:30:59Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-bcb58e4e711c42029a344d8d9d92c2662022-12-21T23:41:50ZengBMCBMC Musculoskeletal Disorders1471-24742019-02-012011610.1186/s12891-019-2463-xComplications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patientsAntonio Klasan0Thomas Neri1Ludwig Oberkircher2Dominik Malcherczyk3Thomas Jan Heyse4Christopher Bliemel5University Hospital Marburg, Center for Orthopedics and TraumatologyDepartment for Orthopedics, University Hospital St. EtienneUniversity Hospital Marburg, Center for Orthopedics and TraumatologyUniversity Hospital Marburg, Center for Orthopedics and TraumatologyOrthomedic Frankfurt OffenbachUniversity Hospital Marburg, Center for Orthopedics and TraumatologyAbstract Background The direct anterior approach (DAA) has gained popularity in total hip arthroplasty (THA) over the past decade. A large number of studies have compared the DAA to other approaches with inclusion of a learning curve phase. The aim of this study was to compare the complication rate and bleeding between the DAA and the anterolateral approach after the learning curve phase. Methods For this retrospective, single-institutional study, propensity score matching was performed, from an initial cohort of 1408 patients receiving an elective THA. Two matching groups were created, comprising of 396 patients each. After matching, both groups were similar in age, gender, body mass index, anesthesiologist’s score and surgeon’s experience. Results Average age in the matched groups was 68.7 ± 10.3 years. The total blood loss was similar in both groups, 450 vs 469 mL (p = 0.400), whereas the transfusion rate (14.1 vs 5.8%, p < 0.001) and the overall complication rate (17.6 vs 12.1%, p = 0.018) were lower in the DAA group. The overall fracture rate was comparable, 1.5 vs 1% (p = 0.376), as well as the early infection rate, 0.3 vs 1% (p = 0.162). The dislocation rate was significantly increased in the DAA group, 2.2 vs 0.5% (p = 0.032). Conclusions The direct anterior approach has comparable short-term surgical complications with reduced transfusion and general complication rates. Level of evidence Level III retrospective study.http://link.springer.com/article/10.1186/s12891-019-2463-xHip arthroplastyDirect anterior approachAnterolateral approachBleedingInfection |
| spellingShingle | Antonio Klasan Thomas Neri Ludwig Oberkircher Dominik Malcherczyk Thomas Jan Heyse Christopher Bliemel Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients BMC Musculoskeletal Disorders Hip arthroplasty Direct anterior approach Anterolateral approach Bleeding Infection |
| title | Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients |
| title_full | Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients |
| title_fullStr | Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients |
| title_full_unstemmed | Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients |
| title_short | Complications after direct anterior versus Watson-Jones approach in total hip arthroplasty: results from a matched pair analysis on 1408 patients |
| title_sort | complications after direct anterior versus watson jones approach in total hip arthroplasty results from a matched pair analysis on 1408 patients |
| topic | Hip arthroplasty Direct anterior approach Anterolateral approach Bleeding Infection |
| url | http://link.springer.com/article/10.1186/s12891-019-2463-x |
| work_keys_str_mv | AT antonioklasan complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients AT thomasneri complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients AT ludwigoberkircher complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients AT dominikmalcherczyk complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients AT thomasjanheyse complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients AT christopherbliemel complicationsafterdirectanteriorversuswatsonjonesapproachintotalhiparthroplastyresultsfromamatchedpairanalysison1408patients |