Complication Rate After Primary Total Hip Arthroplasty Using the Posterior Approach and Enabling Technology: A Consecutive Series of 2,888 Hips

• Published in: The Journal of arthroplasty 2023-07, Vol.38 (7), p.S119-S123.e3
• Main Authors: Anderson, Christopher G., Jang, Seong J., Brilliant, Zachary R., Mayman, David J., Vigdorchik, Jonathan M., Jerabek, Seth A., Sculco, Peter K.
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; complications; direct anterior approach; dislocation; Hip Prosthesis - adverse effects; Humans; Joint Dislocations; Periprosthetic Fractures - epidemiology; Periprosthetic Fractures - etiology; Periprosthetic Fractures - surgery; posterior approach; Postoperative Complications - epidemiology; Postoperative Complications - etiology; readmission; Reoperation - adverse effects; Retrospective Studies; total hip arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2023.04.029

Total hip arthroplasty (THA) is a safe and effective procedure; however, complications such as dislocation, fracture, and infection still occur. It is still unclear whether the dislocation rate via the posterior approach (PA) is better, equal, or worse than the direct anterior approach. Our aim was to report the primary THA dislocation rate via the PA using enabling technology in a large consecutive series of patients. A retrospective cohort of 2,888 primary THAs were reviewed at a single, high-volume, academic institution from January 2018 to September 2021. All patients underwent a THA by 4 fellowship-trained orthopaedic surgeons through the PA with enabling technology. Overall dislocation and readmission rates within 90 days and up to 3 years were analyzed. Of the 2,888 procedures, a total of 39 patients had complications related to the surgery during the 3-year follow-up period. There were 10 patients (0.35%) who experienced a dislocation, with half undergoing surgical revision. Of the 39 patients who experienced complications, 37 (1.3%) were readmitted and 2 underwent revision during their hospital stay. Postoperative periprosthetic fractures were the most common cause for readmission and reoperation at a rate of 0.52% and 0.52%, respectively. The dislocation rate of 0.35% is one of the lowest reported rates via the PA at a mean follow up of 2.1 years and is comparable to previously published rates using alternate approaches. Using contemporary THA with enabling technology, the PA is a reliable approach with respect to dislocation and complication rates after primary THA.