Details

Autor(en) / Beteiligte

• Tripuraneni, Krishna R., MD
• Munson, Natalie, MPH, MBA
• Archibeck, Michael J., MD
• Carothers, Joshua T., MD

Titel

Acetabular Abduction and Dislocations in Direct Anterior versus Posterior Total Hip Arthroplasty: A Retrospective, Matched Cohort Study

Ist Teil von

• The Journal of arthroplasty, 2016

Erscheinungsjahr

2016

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Abstract Background There is purported improvement in component positioning and hip stability with the use of direct anterior approach (DAA) total hip arthroplasty (THA). We sought to determine if there is a difference in acetabular component position or dislocation frequency between DAA and posterior THA. METHODS One arthroplasty fellowship-trained surgeon introduced DAA THA into his practice. From the initiation of DAA in 4/2012 to 8/2015, this comparative series resulted in 66 DAA THAs. A matched cohort (age, sex, BMI, comorbidities) was then created for posterior THA, 66 hips. DAA THA utilized fluoroscopy with anterior capsular excision; posterior group used no image guidance and had capsular repair. Posterior group BMI was 27.8, DAA group BMI was 27.6 (p=0.36). Minimum three-month follow up occurred in both groups. RESULTS Average acetabular abduction angle in the posterior group was 41.9° (range 32°-60°, sdev 6.24) and DAA group 43.8° (range 30°-62°, sdev 6.9), p=0.12. The percentage of outliers (outside Lewinnek safe zone, 30°-50°) was 9.1% (6/66) in posterior group and 13.6% (9/66) in DAA group. There were two anterior dislocations in the DAA THA group and one anterior dislocation in the PTHA group, resulting in p=0.56. The DAA dislocation frequency in this group was overall higher at 3.0% (2/66) compared to the matched posterior (1.5%, 1/66) and unmatched posterior larger series (.8%, 3/360). Conclusion We demonstrated no observable difference in hip stability or acetabular abduction. This study provides realistic outcomes for surgeons implementing DAA THA into their practice.