Perioperative complications and causes of 30- and 90-day readmission after direct anterior approach primary total hip arthroplasty

Sali, Eric; Marmorat, J.-L.; Gaudot, Fabrice; Nich, Christophe

doi:10.1016/j.jor.2019.08.006

Cited by 13 publications

(12 citation statements)

References 28 publications

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“…Some authors [ 15 , 18 ] reported that patients with obesity and advanced age were not suitable for DAA THA, and the risk of complications such as fracture was high. In this study, the patient BMI was heterogeneous, and the continuity analysis did not show that BMI had a significant effect on the incidence of fracture.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis

Sun

Yin

et al. 2021

J Orthop Surg Res

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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.

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Section: Discussionmentioning

confidence: 99%

“…Many hospitals have carried out DAA THA and obtained satisfactory postoperative results [14]. With the increase in the number of operations, however, various intraoperative or postoperative complications have emerged [15]. The incidence of femoral fracture ranges from 0.1 to 22.4% [7,16,17].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis

Sun

Yin

et al. 2021

J Orthop Surg Res

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“…There are many clinical studies on the relationship between obesity and DAA-THA, they put forward many different viewpoints [28][29][30][31][32][33][34][35]. However, there is still no uni ed conclusion on whether obesity have a negative impact on total hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Obesity Affects Short-Term After Total Hip Arthroplasty: A Retrospective Study

Wang

Yang

Zhang

et al. 2021

Preprint

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Background: At present, there are many clinical studies on the impact of obesity on postoperative function following total hip arthroplasty, but their conclusions are different and even contradictory. As abdominal obesity (AO), which is closely related to obesity, we know very little about its impact on postoperative function following total hip arthroplasty.Methods: Sixty-four patients were included in this prospective randomized controlled trial. Divided them into AO group (WC ≥ 90 cm for men and ≥ 85 cm for women) and non-AO group (WC ≤ 90 cm for men and ≤ 85 cm for women). Preoperative assessment included numerical pain rating, the Oxford Hip Score, 6-minute walk test and repeated at 6,12 months postoperatively. Postoperative assessment included the anteversion and inclination of the acetabular prosthesis, satisfaction at 12 months.Results：The hip joint function of both groups has been significantly improved at 1 year postoperatively. No significant differences were found in hip pain or function between the AO and non-AO groups. However, AO patients had poorer walking capacity (p=0.001).Conclusion: AO does not increase the complications after THA, nor does it have a significant impact on the function after THA, but it seems to have a negative effect on the improvement of walking ability.

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“…Some authors [15,18] reported that patients with obesity and advanced age were not suitable for DAA THA, the risk of complications such as fractures was high. In this study, patients had heterogenic BMIs, and the continuity analysis did not show that BMI had a signi cant effect on the incidence of fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Many hospitals have carried out DAA THA and obtained satisfactory postoperative results [14]. With the increase of operations, however, various intraoperative or postoperative complications have emerged [15]. The incidence of femoral fractures varied between 0.1% and 22.4% [7,[16][17].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Femoral Fractures in Lateral Decubitus Direct Anterior Approach Total Hip Arthroplasty Using Conventional Stem: A Retrospective Analysis

Sun

Yin

et al. 2020

Preprint

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Objective: In order to provide guideline to operation and reduce the incidence of fractures, this study analyze the relationship between femoral fractures and related factors in direct anterior approach (DAA) total hip arthroplasty (THA) in lateral decubitus position. Method: A consecutive retrospective series of 273 THA by DAA in lateral decubitus position were analyzed. The surgery were performed by the same surgeon with conventional operation bed and femoral stem. The correlations between incidence of fractures with gender, age, body mass index (BMI), height, osteoporosis, anterior superior iliac spine-greater trochanter distance (ASIS-GTD), and hip-joint diseases were analyzed by univariate analysis and logistic regression analysis. Results: Among all hip arthroplasty, 34 cases had femoral fractures, including 29 greater trochanter fractures, 4 proximal femoral splits and 1 femoral perforation. The incidence of fractures was 13.03%. Univariate analysis: the discrepancies in incidence of fractures among genders, BMIs and age were not significant different; osteoporosis caused an increase of fractures; the incidence of fractures declined as height, ASIS-GTD increased; The incidence of femoral neck fracture and osteonecrosis of femoral head was lower than others. Logistic regression results: there was a significant correlation between osteoporosis, ASIS-GTD and fractures. Patients with osteoporosis had a high possibility of fractures (OR=2.353); the possibility of fractures decreased with an upward ASIS-GTD(OR=0.939). Conclusion: The lateral decubitus DAA THA can be successfully performed using conventional operation bed and stem, which saved medical resources effectively. Osteoporosis and ASIS-GTD were independent risk factors for femoral fractures; Short stature, inflammatory arthroses were relatively risk factors.

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Perioperative complications and causes of 30- and 90-day readmission after direct anterior approach primary total hip arthroplasty

Cited by 13 publications

References 28 publications

Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis

Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis

Abdominal Obesity Affects Short-Term After Total Hip Arthroplasty: A Retrospective Study

Risk Factors of Femoral Fractures in Lateral Decubitus Direct Anterior Approach Total Hip Arthroplasty Using Conventional Stem: A Retrospective Analysis

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