The effect of surgical approach on early complications of total hip arthoplasty.

Abstract

Introduction The primary aim of this study was to determine if different surgical approaches to THA are associated with an increased complication rate requiring either re-admission or re-operation and to determine if these complications were associated with an increased rate of revision. Methodology A case record review was performed of all primary THAs performed at Epworth HealthCare from 1 July 2014 to 30 June 2016. Demographic details collected included age, gender, laterality of the surgery, surgical approach utilised, complications, number of and time to reoperations and details of readmissions. The Epworth HealthCare data were then linked to the Australian Joint Replacement Registry to identify those patients who had been revised for complications related to the index procedure. All statistical analyses were conducted using Stata version 15 Results A total of 2437 THAs were performed during the study time period which were matched to records in the AOANJRR. Of these, 949 (38.9%) were performed via the anterior approach, 618 (25.4%) via the lateral approach, and 870 (35.7%) via the posterior approach. There were 72 (3%) patients who had complications requiring re-admission or re-operation and 28 (1.1% of all THAs) required revision surgery. There was no statistically significant differences in the rates of complications between the 3 different approaches but there was a significantly higher rate of revision for Peri Prosthetic Fracture for patients undergoing the anterior approach. Conclusion The regular MSK audit process at Epworth Healthcare has identified a problem and procedures and policies have been instituted to improve outcomes.