Direct Anterior Approach to the Hip Does Not Increase the Risk for Subsequent Periprosthetic Joint Infection
Copyright © 2021 Elsevier Inc. All rights reserved..
BACKGROUND: Recent studies suggest an increased risk for periprosthetic joint infection (PJI) utilizing the direct anterior (DA) approach to the hip. The purpose of this study was to investigate whether such an increased risk does indeed exist on a large cohort of patients, operated by experienced surgeons and taking into account various confounders.
METHODS: This was a single institutional study, including all patients who underwent primary total hip arthroplasty during the last decade, who were operated on by four high-volume arthroplasty surgeons utilizing a single surgical approach. Three of them utilized the direct lateral (DL) approach while one of them used the DA approach throughout the entire study. Patient characteristics, demographics, and comorbidities were assessed as well as operative and perioperative factors and their association with PJI. Association between surgical approach and PJI was evaluated in a univariate followed by a multivariate regression analysis.
RESULTS: A total of 10,201 patients were included in the study. Of those, 4390 (43.0%) underwent total hip arthroplasty through the DA approach and 5811 (57.0%) through the DL approach. PJI rates were 0.9% (38/4390) in the DA group compared with 1.3% (73/5811) in the DL group (P = .068). Results from a regression analysis showed no significant association between PJI and DA approach (adjusted odds ratio 0.760, 95% confidence interval 0.428-1.348, P = .348). The risk remained nonsignificant in patients with higher body mass index. There were also no significant differences in the infecting organisms between the two groups.
CONCLUSION: The DA approach to the hip does not increase the risk for subsequent PJI.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
|---|---|
| Enthalten in: |
The Journal of arthroplasty - 36(2021), 6 vom: 26. Juni, Seite 2038-2043 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shohat, Noam [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Direct anterior approach |
|---|
| Anmerkungen: |
Date Completed 29.06.2021 Date Revised 29.06.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.arth.2021.02.016 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM322064805 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM322064805 | ||
| 003 | DE-627 | ||
| 005 | 20231225181234.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.arth.2021.02.016 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1073.xml |
| 035 | |a (DE-627)NLM322064805 | ||
| 035 | |a (NLM)33648842 | ||
| 035 | |a (PII)S0883-5403(21)00142-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shohat, Noam |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Direct Anterior Approach to the Hip Does Not Increase the Risk for Subsequent Periprosthetic Joint Infection |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.06.2021 | ||
| 500 | |a Date Revised 29.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Recent studies suggest an increased risk for periprosthetic joint infection (PJI) utilizing the direct anterior (DA) approach to the hip. The purpose of this study was to investigate whether such an increased risk does indeed exist on a large cohort of patients, operated by experienced surgeons and taking into account various confounders | ||
| 520 | |a METHODS: This was a single institutional study, including all patients who underwent primary total hip arthroplasty during the last decade, who were operated on by four high-volume arthroplasty surgeons utilizing a single surgical approach. Three of them utilized the direct lateral (DL) approach while one of them used the DA approach throughout the entire study. Patient characteristics, demographics, and comorbidities were assessed as well as operative and perioperative factors and their association with PJI. Association between surgical approach and PJI was evaluated in a univariate followed by a multivariate regression analysis | ||
| 520 | |a RESULTS: A total of 10,201 patients were included in the study. Of those, 4390 (43.0%) underwent total hip arthroplasty through the DA approach and 5811 (57.0%) through the DL approach. PJI rates were 0.9% (38/4390) in the DA group compared with 1.3% (73/5811) in the DL group (P = .068). Results from a regression analysis showed no significant association between PJI and DA approach (adjusted odds ratio 0.760, 95% confidence interval 0.428-1.348, P = .348). The risk remained nonsignificant in patients with higher body mass index. There were also no significant differences in the infecting organisms between the two groups | ||
| 520 | |a CONCLUSION: The DA approach to the hip does not increase the risk for subsequent PJI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a direct anterior approach | |
| 650 | 4 | |a direct lateral | |
| 650 | 4 | |a periprosthetic joint infection | |
| 650 | 4 | |a risk | |
| 650 | 4 | |a surgical approach | |
| 650 | 4 | |a total hip arthroplasty | |
| 700 | 1 | |a Goswami, Karan |e verfasserin |4 aut | |
| 700 | 1 | |a Clarkson, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Chisari, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Breckenridge, Leigham |e verfasserin |4 aut | |
| 700 | 1 | |a Gursay, D'Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Timothy L |e verfasserin |4 aut | |
| 700 | 1 | |a Parvizi, Javad |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of arthroplasty |d 1995 |g 36(2021), 6 vom: 26. Juni, Seite 2038-2043 |w (DE-627)NLM012629375 |x 1532-8406 |7 nnns |
| 773 | 1 | 8 | |g volume:36 |g year:2021 |g number:6 |g day:26 |g month:06 |g pages:2038-2043 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.arth.2021.02.016 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 36 |j 2021 |e 6 |b 26 |c 06 |h 2038-2043 | ||