A low dislocation rate after revision total hip arthroplasty performed through the anterior approach

Abstract

Background Dislocation is a major complication in revision total hip arthroplasties. This study aimed to evaluate the dislocation rate, complications, and functional scores of revision total hip arthroplasty performed through the direct anterior approach. Methods Between January 2014 and March 2020, 84 patients undergoing revision total hip arthroplasty were retrospectively reviewed. All operations were performed through the direct anterior approach. At the final follow-up, incidences of dislocation, reoperation, acute deep infections, periprosthetic fractures and psoas impingement were assessed. The median postoperative Oxford Hip Score was also calculated. Results At revision surgery, the mean age was 66 ± 12 years (range, 28–91). During an average follow-up of 4.2 ± 1.2 years, reoperation rate for major complications in the non-infected revisions was 15% (n = 11), including five acute deep infections (7%), four periprosthetic fractures (5%), one dislocation and one psoas impingement (1%). The median postoperative Oxford Hip Score was 39 (interquartile range = 14). Conclusion In our series, revision total hip arthroplasty through direct anterior approach was associated with a very low dislocation rate, acceptable complication rates and good functional results. Our results suggest that this procedure is safe and reliable. Trial registration Ethical approval for this study was obtained, before enrollment of the first participant, by CUB Erasme's research ethics committee (P2020/323) and C.H.U Ambroise Paré's research ethics committee.

Surgical Approaches in Total Hip Arthroplasty

“…Early rates of THA failure have been reportedly increasing ranging from 24% to 50% within 5 years of the surgery due to femoral or acetabular prosthetic fracture, mal-alignment, or instability [ 19 - 21 ]. A study reported early femoral periprosthetic fractures and loosening were significantly higher in the DAA when compared to the LA and PA. Additionally, early femoral component loosening was higher with DAA than LA and PA [ 19 , 22 ]. Malalignment of the acetabular cup causes impingement, dislocation, and loosening of the acetabular component [ 23 ].…”