Comparison of 90-Day Complications Between Direct Anterior and Postero-Lateral Total Hip Arthroplasty in Morbidly Obese Patients.
Direct anterior approach linked to lower revision surgery odds in morbidly obese patients
Comparison of 90-Day Complications Between Direct Anterior and Postero-Lateral Total Hip Arthroplasty in Morbidly Obese Patients.
Morbidly obese (morbidly obese) patients undergoing total hip arthroplasty (total hip arthroplasty) are at increased risk of postoperative complications.
This study compared perioperative outcomes and 90-day complications between direct anterior (direct anterior) and postero-lateral (postero-lateral) approaches in morbidly obese and non-morbidly obese patients.
We retrospectively reviewed 5,933 primary THAs between January 2017 and March 2022.
revision surgery was less likely after the anterior approach
In morbidly obese patients, operative times were significantly shorter with direct anterior (71 ± 18 versus 92 ± 26 minutes, P < 0.001).
On penalized multivariable analysis, there was a reduced risk of periprosthetic fracture for the direct anterior group (OR [odds ratio] 0.08, 95% CI [confidence interval] 0.01 to 0.89); however, interpretation is limited by higher rates of cementation in the direct anterior group.
In morbidly obese patients undergoing total hip arthroplasty, the direct anterior approach was associated with shorter operative times.
After multivariate adjustment, overall complication risks were similar between approaches across two analytical frameworks.
These findings suggest that both direct anterior and postero-lateral can be safely utilized in morbidly obese patients undergoing total hip arthroplasty, without an increased 90-day complication profile attributable to either approach.