Anterior approach to hip replacement and associated complications: an independent review

Direct anterior approach (DAA) to hip replacement is increasingly popular. Despite the well-published benefits of early recovery, the approach can be associated with a number of complications that may be underreported. We aim to report the incidence of some of these complications in a large retrospe...

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Published inHip international Vol. 32; no. 3; p. 312
Main Authors Vasantharao, Praveen, Fenbury, David, Khan, Riaz, Fick, Daniel, Dalgleish, Stephen, Finsterwald, Michael, Castle, Hannah, Haebich, Samantha
Format Journal Article
LanguageEnglish
Published United States 01.05.2022
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Abstract Direct anterior approach (DAA) to hip replacement is increasingly popular. Despite the well-published benefits of early recovery, the approach can be associated with a number of complications that may be underreported. We aim to report the incidence of some of these complications in a large retrospective case series. 270 consecutive DAA hip replacements are studied which are performed by a single high-volume hip surgeon from 2013 to 2015, not including the surgeon's learning curve. Operation and consultation records were screened, and focused questioning via telephone was employed to capture specific complications including dislocations, wound infections, lateral femoral cutaneous nerve (LFCN) injury and revision surgery. 240 of 270 patients or family were contactable. The mean age and body mass index of the cohort was 66 (range 30-89) years and 27 (range 18-40) kg/m respectively. The mean follow-up was 3.7 years. Wound issues were encountered in 24 patients (8.8%). There were 9 dislocations (3%). 27 (10%) patients needed revision surgery in the follow-up period. Reasons for revision included leg-length discrepancies, dislocations, ongoing pain and aseptic loosening. 9 (3.4%) patients had to return to operating theatre for reasons other than revision surgery. Symptoms of lateral femoral cutaneous nerve injury was reported by 54 patients (21%). While the short-term benefits of DAA have been widely reported, our review shows a relatively high rate of revision surgery. We feel that the enthusiasm for DAA should be tempered until further evidence is available.
AbstractList Direct anterior approach (DAA) to hip replacement is increasingly popular. Despite the well-published benefits of early recovery, the approach can be associated with a number of complications that may be underreported. We aim to report the incidence of some of these complications in a large retrospective case series. 270 consecutive DAA hip replacements are studied which are performed by a single high-volume hip surgeon from 2013 to 2015, not including the surgeon's learning curve. Operation and consultation records were screened, and focused questioning via telephone was employed to capture specific complications including dislocations, wound infections, lateral femoral cutaneous nerve (LFCN) injury and revision surgery. 240 of 270 patients or family were contactable. The mean age and body mass index of the cohort was 66 (range 30-89) years and 27 (range 18-40) kg/m respectively. The mean follow-up was 3.7 years. Wound issues were encountered in 24 patients (8.8%). There were 9 dislocations (3%). 27 (10%) patients needed revision surgery in the follow-up period. Reasons for revision included leg-length discrepancies, dislocations, ongoing pain and aseptic loosening. 9 (3.4%) patients had to return to operating theatre for reasons other than revision surgery. Symptoms of lateral femoral cutaneous nerve injury was reported by 54 patients (21%). While the short-term benefits of DAA have been widely reported, our review shows a relatively high rate of revision surgery. We feel that the enthusiasm for DAA should be tempered until further evidence is available.
Author Dalgleish, Stephen
Khan, Riaz
Castle, Hannah
Finsterwald, Michael
Vasantharao, Praveen
Fenbury, David
Fick, Daniel
Haebich, Samantha
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CitedBy_id crossref_primary_10_1051_sicotj_2023008
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crossref_primary_10_1016_j_asmr_2022_10_013
crossref_primary_10_2106_JBJS_CC_21_00614
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Keywords direct anterior approach
revision surgery
Complications
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Snippet Direct anterior approach (DAA) to hip replacement is increasingly popular. Despite the well-published benefits of early recovery, the approach can be...
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StartPage 312
SubjectTerms Adult
Aged
Aged, 80 and over
Antiviral Agents
Arthroplasty, Replacement, Hip - adverse effects
Humans
Joint Dislocations
Leg Length Inequality
Middle Aged
Reoperation
Retrospective Studies
Title Anterior approach to hip replacement and associated complications: an independent review
URI https://www.ncbi.nlm.nih.gov/pubmed/32787466
Volume 32
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