Femoral Revision Total Hip Arthroplasty Performed through the Interval of the Direct Anterior Approach.

Martin Thaler,Hermann Leitner,Michael Nogler,Michael Ban,Dietmar Dammerer,Ismail Khosravi

doi:10.3390/jcm10020337

Martin Thaler, Hermann Leitner + Show 4 more

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https://doi.org/10.3390/jcm10020337

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Abstract

Background: we report the clinical outcomes for femoral revision total hip replacement (THR) using the Direct Anterior Approach (DAA) interval. Methods: 149 patients (165 hips) with a mean age of 68.9 years (range, 33.2–91.0 years) and a mean follow-up of 4.2 years (1.1–8.9 years) were included. The indication for revision surgery was aseptic stem loosening in 131 (79.4%) hips, periprosthetic fracture in 29 (17.6%) hips, revision for stem malalignment in one (0.6%) hip, and prosthetic failure in four (2.4%) hips. Results: an endofemoral approach was used for 156 hips, and a Wagner transfemoral osteotomy was used for nine hips. An additional cup revision was done in 52 hips (uncemented cup: n = 29; cemented cup: n = 21; acetabular cage: n = 2). The overall complication rate was 14.5% (24 complications). Ten patients (10 hips) were revised (8 cups, 2 liners, 2 stems) with an average time to revision of 6 months (range, 3–23 months). The median preoperative Western Ontario McMasters Osteoarthritis Score (WOMAC) score was 52.5 (Inter Quartile Range (IQR): 33.3), which improved to 27.2 (IQR: 30) postoperatively (p < 0.01). Conclusion: use of the DAA achieved similar results when compared with other surgical approaches in terms of clinical outcomes and complications, including dislocation rate. These results suggest that femoral revision using the DAA interval can be a safe and reliable procedure.

Highlights

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Projection analysis based on registry data indicates that the number of hip revision cases will double by the year 2026 [1]
The purpose of this study was to evaluate in a large case series the outcomes of femoral stem revision Total hip arthroplasty (THA) conducted through the Direct Anterior Approach (DAA) interval with regard to complication rates, including dislocation rates, and clinical and functional outcomes

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Total hip arthroplasty (THA) is one of the most successful types of surgery performed. It can relieve pain and restore function in patients with diagnoses, such as osteoarthritis of the hip and femoral head necrosis. The number of primary THA procedures is estimated to increase significantly during the coming decades [1,2,3]. The number of THA revision procedures will likely increase . Projection analysis based on registry data indicates that the number of hip revision cases will double by the year 2026 [1]

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