Anna Jungwirth-Weinberger1,2, Tom Schmidt-Braekling3, Kilian Rueckl4, Bernhard Springer5, Friedrich Boettner6. 1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. 2. Kantonsspital Baden, Im Ergel 1, 5404, Baden, Switzerland. 3. Uniklinikum Münster, Domagkstraße 5, 48149, Münster, Germany. 4. Julius-Maximilians-Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Germany. 5. AKH Wien, Währinger Gürtel 18-20, 1090, Wien, Austria. 6. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. boettnerf@hss.edu.
Abstract
INTRODUCTION: Dislocation in Total hip arthroplasty (THA) is a common postoperative complication and reason for revision surgery. The direct anterior approach has become more popular over the last decade. The purpose of this study was to compare postoperative dislocation rates of the direct anterior and the posterior approach at a one-year follow-up. MATERIAL AND METHODS: 797 consecutive hips operated through a posterior approach [698 patients (307 male, 391 female)] between 2009 and 2012, were compared to 690 selected THA [610 patients (423 female, 187 male)] operated since 2012. Anterior hip replacement surgery was primarily indicated for patients demanding increased flexibility after surgery (Yoga) or were considered a higher risk for dislocation. RESULTS: During a one-year follow-up there were eight dislocations out of 797 THA (1%) in the posterior group and none in the 690 THA (0%) in the anterior group (p-value of 0.008). Average time to dislocation was 7.5 weeks in the posterior group. Five of eight patients with dislocations needed revision surgery due to persistent instability. CONCLUSION: Even in a higher-risk patient population, the direct anterior approach showed a lower dislocation rate compared to the posterior approach in the first year after surgery.
INTRODUCTION: Dislocation in Total hip arthroplasty (THA) is a common postoperative complication and reason for revision surgery. The direct anterior approach has become more popular over the last decade. The purpose of this study was to compare postoperative dislocation rates of the direct anterior and the posterior approach at a one-year follow-up. MATERIAL AND METHODS: 797 consecutive hips operated through a posterior approach [698 patients (307 male, 391 female)] between 2009 and 2012, were compared to 690 selected THA [610 patients (423 female, 187 male)] operated since 2012. Anterior hip replacement surgery was primarily indicated for patients demanding increased flexibility after surgery (Yoga) or were considered a higher risk for dislocation. RESULTS: During a one-year follow-up there were eight dislocations out of 797 THA (1%) in the posterior group and none in the 690 THA (0%) in the anterior group (p-value of 0.008). Average time to dislocation was 7.5 weeks in the posterior group. Five of eight patients with dislocations needed revision surgery due to persistent instability. CONCLUSION: Even in a higher-risk patient population, the direct anterior approach showed a lower dislocation rate compared to the posterior approach in the first year after surgery.
Authors: Michael S Kwon; Michael Kuskowski; Kevin J Mulhall; William Macaulay; Thomas E Brown; Khaled J Saleh Journal: Clin Orthop Relat Res Date: 2006-06 Impact factor: 4.176
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