Background: Recent studies suggest an increased risk for periprosthetic joint infection (PJI) utilizing the direct anterior (DA) approach to the hip. The purpose of this study was to investigate whether such an increased risk does indeed exist on a large cohort of patients, operated by experienced surgeons and taking into account various confounders.

Methods: This was a single institutional study, including all patients who underwent primary total hip arthroplasty during the last decade, who were operated on by four high-volume arthroplasty surgeons utilizing a single surgical approach. Three of them utilized the direct lateral (DL) approach while one of them used the DA approach throughout the entire study. Patient characteristics, demographics, and comorbidities were assessed as well as operative and perioperative factors and their association with PJI. Association between surgical approach and PJI was evaluated in a univariate followed by a multivariate regression analysis.

Results: A total of 10,201 patients were included in the study. Of those, 4390 (43.0%) underwent total hip arthroplasty through the DA approach and 5811 (57.0%) through the DL approach. PJI rates were 0.9% (38/4390) in the DA group compared with 1.3% (73/5811) in the DL group (P = .068). Results from a regression analysis showed no significant association between PJI and DA approach (adjusted odds ratio 0.760, 95% confidence interval 0.428-1.348, P = .348). The risk remained nonsignificant in patients with higher body mass index. There were also no significant differences in the infecting organisms between the two groups.

Conclusion: The DA approach to the hip does not increase the risk for subsequent PJI.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arth.2021.02.016DOI Listing

Publication Analysis

Top Keywords

approach hip
12
approach
10
direct anterior
8
anterior approach
8
hip increase
8
increase risk
8
risk subsequent
8
periprosthetic joint
8
joint infection
8
increased risk
8

Similar Publications

Introduction: The average body mass index (BMI) in the United States has tripled over the last five decades despite concerted population-based efforts for weight management. Elevated BMI and, in particular, obesity are risk factors for osteoarthritis. This trend has led to increased demands for total knee (TKA) and total hip arthroplasty (THA), necessitating an in-depth understanding of how elevated BMI impacts TKA and THA.

View Article and Find Full Text PDF

What is the lower limb length discrepancy after arthroplasty for proximal femoral fracture? A prospective, multicenter observational study of 590 hips.

Orthop Traumatol Surg Res

December 2024

Société Française de Chirurgie Orthopédique et Traumatologique, 56 rue Boissonade, 75014 Paris Cedex, France.

Introduction: Lower limb length discrepancy (LLD) following hip arthroplasty after proximal femoral fracture (PFFA) is little studied. The aim of this work was to answer the following questions: 1) What are the incidence and mean values ​​of LLD after PFFA? 2) What are the clinical consequences (tolerance) of LLD after PFFA? 3) Can we identify risk factors for LLD after PFFA? 4) Is there a significant difference in terms of LLD after PFFA to treat intra- versus extra-capsular fractures?

Hypothesis: LLD after proximal femoral fracture arthroplasty is rare but has good clinical tolerance, given the low functional demands of the patients.

Patients And Methods: This is a multicenter prospective observational cohort study (15 centers), including 590 patients, operated on for hip arthroplasty for proximal femur fracture between May 2022 and June 2023.

View Article and Find Full Text PDF

Background: Accurate component placement plays a critical role in the outcome of total hip arthroplasty (THA). Robotic-assisted THA (R-THA) has emerged as an option to optimize this aspect compared to the conventional manual THA (C-THA). The aim of this meta-analysis was to analyze the studies comparing R-THA and C-THA.

View Article and Find Full Text PDF

Purpose: This study investigated the epidemiology, risk factors, and outcomes of sepsis, a life-threatening complication, in the context of periprosthetic joint infections (PJI) of the hip and knee.

Methods: Sepsis was determined using the Sepsis-1 criteria. The cohort with PJI and sepsis was compared to patients who had PJI without sepsis.

View Article and Find Full Text PDF

Introduction: Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD.

Materials And Methods: Consecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!