Thirty-Day Major and Minor Complications Following Total Hip Arthroplasty—A Comparison of the Direct Anterior, Lateral, and Posterior Approaches

Adam Hart, Cody C. Wyles, Matthew Abdel, Kevin I. Perry, Mark Pagnano, Michael J. Taunton

Research output: Contribution to journalArticle

Abstract

Background: The choice of surgical approach during total hip arthroplasty (THA) remains highly controversial. The aim of the present study was to compare 30-day major and minor complications, following primary THA between the direct anterior, lateral, and posterior approaches. Methods: Our hospital performs primary THAs using all 3 aforementioned approaches based on surgeon preference. Patients who underwent primary THA from August 2010 to August 2017 were identified using our institution's total joint registry, and their data were combined with prospectively collected data from the National Surgical Quality Improvement Program database (which evaluates a random sample of approximately 20% of all surgical patients in our hospital). Baseline characteristics, operative variables, and postoperative complications were then compared between the three groups. Results: The analysis comprised 1967 primary THAs (1913 patients), whereby 56%, 29%, and 15% were performed through a posterior, lateral, and direct anterior approach, respectively. Thirty-day major and minor complications occurred in 3.9% and 9.4% of surgeries, respectively. After adjusting for baseline patient characteristics, there was no significant difference in major or minor perioperative complications between the 3 approaches. Conclusions: This study compared perioperative complications between the 3 most commonly used approaches for THA utilizing a synthesis of our institutional total joint registry and high-quality National Surgical Quality Improvement Program data. Thirty-day major and minor complications were similar regardless of the surgical approach employed, which may help surgeons and patients simplify the multiple considerations taken into account when deciding on surgical approach for primary THA. Level of Evidence: Therapeutic, Level III.

Original languageEnglish (US)
JournalJournal of Arthroplasty
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Arthroplasty
Hip
Tacrine
Quality Improvement
Registries
Joints
Databases
Surgeons
Therapeutics

Keywords

  • hip replacement
  • morbidity
  • NSQIP
  • perioperative complications
  • surgical approach

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Thirty-Day Major and Minor Complications Following Total Hip Arthroplasty—A Comparison of the Direct Anterior, Lateral, and Posterior Approaches. / Hart, Adam; Wyles, Cody C.; Abdel, Matthew; Perry, Kevin I.; Pagnano, Mark; Taunton, Michael J.

In: Journal of Arthroplasty, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background: The choice of surgical approach during total hip arthroplasty (THA) remains highly controversial. The aim of the present study was to compare 30-day major and minor complications, following primary THA between the direct anterior, lateral, and posterior approaches. Methods: Our hospital performs primary THAs using all 3 aforementioned approaches based on surgeon preference. Patients who underwent primary THA from August 2010 to August 2017 were identified using our institution's total joint registry, and their data were combined with prospectively collected data from the National Surgical Quality Improvement Program database (which evaluates a random sample of approximately 20{\%} of all surgical patients in our hospital). Baseline characteristics, operative variables, and postoperative complications were then compared between the three groups. Results: The analysis comprised 1967 primary THAs (1913 patients), whereby 56{\%}, 29{\%}, and 15{\%} were performed through a posterior, lateral, and direct anterior approach, respectively. Thirty-day major and minor complications occurred in 3.9{\%} and 9.4{\%} of surgeries, respectively. After adjusting for baseline patient characteristics, there was no significant difference in major or minor perioperative complications between the 3 approaches. Conclusions: This study compared perioperative complications between the 3 most commonly used approaches for THA utilizing a synthesis of our institutional total joint registry and high-quality National Surgical Quality Improvement Program data. Thirty-day major and minor complications were similar regardless of the surgical approach employed, which may help surgeons and patients simplify the multiple considerations taken into account when deciding on surgical approach for primary THA. Level of Evidence: Therapeutic, Level III.",
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