Guanjun Sun1, Yi Yin2, Yongjie Ye2, Qingshan Li2. 1. Suining Central Hospital, Suining, China. Hxsungj@163.com. 2. Suining Central Hospital, Suining, China.
Abstract
OBJECTIVE: To provide guidelines for surgery and reduce the incidence of fracture, this study analyzed the relationship between femoral fracture and related factors in direct anterior approach (DAA) total hip arthroplasty (THA) in the lateral decubitus position. METHOD: A retrospective series of 273 consecutive patients who underwent THA with the DAA in the lateral decubitus position was analyzed. Each surgery was performed by the same surgeon with a conventional operation bed and femoral stem. The correlations between the incidence of fracture and sex, age, body mass index (BMI), height, osteoporosis, the anterior superior iliac spine-greater trochanter distance (ASIS-GTD), and hip joint disease were analyzed by univariate analysis and logistic regression analysis. RESULTS: Among all hip arthroplasty procedures, 35 hips had femoral fractures, including 30 greater trochanter fractures, 4 proximal femoral splits, and 1 femoral perforation. The incidence of fracture was 12.82%. Univariate analysis showed no significant difference in the incidence of fracture by sex, BMI, or age. However, osteoporosis caused an increase in the incidence of fracture, while the incidence of fracture decreased as height and the ASIS-GTD increased. The incidence of femoral neck fracture was lower in cases of osteonecrosis of the femoral head than in cases of other diseases. Logistic regression showed a significant correlation between osteoporosis, the ASIS-GTD, and fractures. Patients with osteoporosis had a high possibility of fracture (OR = 2.414); the possibility of fracture decreased with increasing ASIS-GTD (OR = 0.938). CONCLUSION: Lateral decubitus DAA THA can be successfully performed using a conventional operation bed and stem, effectively saving medical resources. Osteoporosis and a shorter ASIS-GTD were independent risk factors for femoral fracture.
OBJECTIVE: To provide guidelines for surgery and reduce the incidence of fracture, this study analyzed the relationship between femoral fracture and related factors in direct anterior approach (DAA) total hip arthroplasty (THA) in the lateral decubitus position. METHOD: A retrospective series of 273 consecutive patients who underwent THA with the DAA in the lateral decubitus position was analyzed. Each surgery was performed by the same surgeon with a conventional operation bed and femoral stem. The correlations between the incidence of fracture and sex, age, body mass index (BMI), height, osteoporosis, the anterior superior iliac spine-greater trochanter distance (ASIS-GTD), and hip joint disease were analyzed by univariate analysis and logistic regression analysis. RESULTS: Among all hip arthroplasty procedures, 35 hips had femoral fractures, including 30 greater trochanter fractures, 4 proximal femoral splits, and 1 femoral perforation. The incidence of fracture was 12.82%. Univariate analysis showed no significant difference in the incidence of fracture by sex, BMI, or age. However, osteoporosis caused an increase in the incidence of fracture, while the incidence of fracture decreased as height and the ASIS-GTD increased. The incidence of femoral neck fracture was lower in cases of osteonecrosis of the femoral head than in cases of other diseases. Logistic regression showed a significant correlation between osteoporosis, the ASIS-GTD, and fractures. Patients with osteoporosis had a high possibility of fracture (OR = 2.414); the possibility of fracture decreased with increasing ASIS-GTD (OR = 0.938). CONCLUSION: Lateral decubitus DAA THA can be successfully performed using a conventional operation bed and stem, effectively saving medical resources. Osteoporosis and a shorter ASIS-GTD were independent risk factors for femoral fracture.
Authors: Kyle H Cichos; Scott E Mabry; Clay A Spitler; Gerald McGwin; Jonathan H Quade; Elie S Ghanem Journal: J Orthop Trauma Date: 2021-01-01 Impact factor: 2.512
Authors: John M Yanik; Nicholas A Bedard; Jessica M Hanley; Jesse E Otero; John J Callaghan; John L Marsh Journal: J Arthroplasty Date: 2018-07-11 Impact factor: 4.757
Authors: Javier Ripollés-Melchor; Ane Abad-Motos; Yolanda Díez-Remesal; Marta Aseguinolaza-Pagola; Lidia Padin-Barreiro; Rubén Sánchez-Martín; Margarita Logroño-Egea; Juan C Catalá-Bauset; Silvia García-Orallo; Elvira Bisbe; Nuria Martín; Alejandro Suárez-de-la-Rica; Ana B Cuéllar-Martínez; Silvia Gil-Trujillo; Juan Carlos Estupiñán-Jiménez; Marta Villanova-Baraza; Cristina Gil-Lapetra; Pilar Pérez-Sánchez; Nicolás Rodríguez-García; Alvaro Ramiro-Ruiz; Carla Farré-Tebar; Alejandro Martínez-García; Pedro Arauzo-Pérez; Cristina García-Pérez; Alfredo Abad-Gurumeta; María A Miñambres-Villar; Alberto Sánchez-Campos; Ignacio Jiménez-López; José M Tena-Guerrero; Oliver Marín-Peña; Míriam Sánchez-Merchante; Ubaldo Vicente-Gutiérrez; María C Cassinello-Ogea; Carlos Ferrando-Ortolá; Héctor Berges-Gutiérrez; Jesús Fernanz-Antón; Manuel A Gómez-Ríos; Daniel Bordonaba-Bosque; José M Ramírez-Rodríguez; José Antonio García-Erce; César Aldecoa Journal: JAMA Surg Date: 2020-04-15 Impact factor: 14.766
Authors: David C Grossman; Susan J Curry; Douglas K Owens; Michael J Barry; Aaron B Caughey; Karina W Davidson; Chyke A Doubeni; John W Epling; Alex R Kemper; Alex H Krist; Martha Kubik; Seth Landefeld; Carol M Mangione; Michael Pignone; Michael Silverstein; Melissa A Simon; Chien-Wen Tseng Journal: JAMA Date: 2018-04-24 Impact factor: 56.272