We have located links that may give you full text access.
Is Direct Anterior Approach a Credible Option for Severely Obese Patients Undergoing Total Hip Arthroplasty? A Matched-Control, Retrospective, Clinical Study.
Journal of Arthroplasty 2018 August
BACKGROUND: Severely obese patients present a significant challenge for arthroplasty surgeons because of their body habitus. Up to date, there is no clear consensus on the safety of the direct anterior approach (DAA) in obese patients undergoing total hip arthroplasty. Therefore, the purpose of the present study was to determine whether DAA is a credible option in severely obese regarding complication rates, clinical outcomes, and component positioning.
METHODS: Obese patients with a body mass index ≥ 35 kg/m2 (n = 129) who received total hip arthroplasty with DAA in our institution were matched for gender and age with nonobese patients with body mass index ≤ 25 kg/m2 (n = 125). The postoperative complications and clinical and radiologic outcomes were assessed retrospectively.
RESULTS: The results of this study showed an increased risk of reoperation (relative risk: 4.0), mostly due to wound infection and dehiscence, in obese than in nonobese patients. The mean Harris Hip Score increased from 50 and 42 preoperative to 95 and 97 at the 1-year follow-up in obese patients and nonobese patients, respectively. No significant difference was observed regarding the acetabular anteversion, inclination or leg-length discrepancy, and vertical center of rotation. The horizontal center of rotation was slightly medialized (4 mm) in the nonobese compared with the obese patients (1 mm).
CONCLUSION: Obese patients had a higher complication and reoperation rate compared with nonobese patients. However, these rates were comparable to the rates of the standard, more extensive approaches presented in the literature. The current data suggest that DAA might be a credible option for obese patients, with excellent functional and radiographic outcomes.
METHODS: Obese patients with a body mass index ≥ 35 kg/m2 (n = 129) who received total hip arthroplasty with DAA in our institution were matched for gender and age with nonobese patients with body mass index ≤ 25 kg/m2 (n = 125). The postoperative complications and clinical and radiologic outcomes were assessed retrospectively.
RESULTS: The results of this study showed an increased risk of reoperation (relative risk: 4.0), mostly due to wound infection and dehiscence, in obese than in nonobese patients. The mean Harris Hip Score increased from 50 and 42 preoperative to 95 and 97 at the 1-year follow-up in obese patients and nonobese patients, respectively. No significant difference was observed regarding the acetabular anteversion, inclination or leg-length discrepancy, and vertical center of rotation. The horizontal center of rotation was slightly medialized (4 mm) in the nonobese compared with the obese patients (1 mm).
CONCLUSION: Obese patients had a higher complication and reoperation rate compared with nonobese patients. However, these rates were comparable to the rates of the standard, more extensive approaches presented in the literature. The current data suggest that DAA might be a credible option for obese patients, with excellent functional and radiographic outcomes.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app