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Surgical Approach Does Not Influence Instability Risk in Revision Total Hip Arthroplasty.
Secrist, Eric S; Boutelle, Kelly; Pekas, Devon R; Neal, David C; Adrados, Murillo; Moskal, Joseph T; Coobs, Benjamin R.
Afiliación
  • Secrist ES; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia.
  • Boutelle K; Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
  • Pekas DR; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia.
  • Neal DC; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia.
  • Adrados M; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia; Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
  • Moskal JT; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia; Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
  • Coobs BR; Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics & Neurosciences, Roanoke, Virginia; Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
J Arthroplasty ; 39(9S1): S166-S172, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38871065
ABSTRACT

BACKGROUND:

Although the direct anterior (DA) approach has increased in popularity for primary total hip arthroplasty (THA), there is limited evidence regarding its use for revision THA. It is unknown whether the dislocation benefit seen in the primary setting translates to revision cases.

METHODS:

This retrospective review compared the dislocation rates of revision THA performed through DA versus postero-lateral (PL) approaches at a single institution (2011 to 2021). Exclusion criteria included revision for instability, ≥ 2 prior revisions, approaches other than DA or PL, and placement of dual-mobility or constrained liners. There were 182 hips in 173 patients that met the inclusion criteria. The average follow-up was 6.5 years (range, 2 to 8 years).

RESULTS:

There was a trend toward more both-component revisions being performed through the PL approach. There were no differences in dislocation rates between the DA revision and PL revision cohorts, which were 8.1% (5 of 72) and 7.5% (9 of 120), respectively (P = .999). Dislocation trended lower when the revision approach was discordant from the primary approach compared to cases where primary and revision had a concordant approach (4.9 versus 8.5%), but this was not statistically significant (P = .740). No significant differences were found in return to operating room, 90-day emergency department visits, or 90-day readmissions. However, the length of stay was significantly shorter in patients who had DA revisions after a primary PL procedure (P = .021).

CONCLUSIONS:

Dislocation rates following revision THA did not differ between the DA and PL approaches irrespective of the primary approach. Surgeons should choose their revision approach based on their experience and the specific needs of the patient.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Artroplastia de Reemplazo de Cadera Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Artroplastia de Reemplazo de Cadera Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos