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Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component

Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetr...

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Autores principales: Prodinger, Peter Michael, Lazic, Igor, Horas, Konstantin, Burgkart, Rainer, von Eisenhart-Rothe, Rüdiger, Weissenberger, Manuel, Rudert, Maximilian, Holzapfel, Boris Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564155/
https://www.ncbi.nlm.nih.gov/pubmed/32967075
http://dx.doi.org/10.3390/jcm9093031
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author Prodinger, Peter Michael
Lazic, Igor
Horas, Konstantin
Burgkart, Rainer
von Eisenhart-Rothe, Rüdiger
Weissenberger, Manuel
Rudert, Maximilian
Holzapfel, Boris Michael
author_facet Prodinger, Peter Michael
Lazic, Igor
Horas, Konstantin
Burgkart, Rainer
von Eisenhart-Rothe, Rüdiger
Weissenberger, Manuel
Rudert, Maximilian
Holzapfel, Boris Michael
author_sort Prodinger, Peter Michael
collection PubMed
description Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12–56). Survival rates were estimated using the Kaplan–Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan–Meier analysis revealed an estimated five-year implant survival of 97% (confidence interval CI 87–99%). The estimated five-year survival with revision for any cause was 93% (CI 83–98%). The overall revision rate was 6.6% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2–66) preoperatively to 86 (38–100) postoperatively (p < 0.001). The hip joint’s anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results.
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spelling pubmed-75641552020-10-26 Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component Prodinger, Peter Michael Lazic, Igor Horas, Konstantin Burgkart, Rainer von Eisenhart-Rothe, Rüdiger Weissenberger, Manuel Rudert, Maximilian Holzapfel, Boris Michael J Clin Med Article Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12–56). Survival rates were estimated using the Kaplan–Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan–Meier analysis revealed an estimated five-year implant survival of 97% (confidence interval CI 87–99%). The estimated five-year survival with revision for any cause was 93% (CI 83–98%). The overall revision rate was 6.6% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2–66) preoperatively to 86 (38–100) postoperatively (p < 0.001). The hip joint’s anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results. MDPI 2020-09-21 /pmc/articles/PMC7564155/ /pubmed/32967075 http://dx.doi.org/10.3390/jcm9093031 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Prodinger, Peter Michael
Lazic, Igor
Horas, Konstantin
Burgkart, Rainer
von Eisenhart-Rothe, Rüdiger
Weissenberger, Manuel
Rudert, Maximilian
Holzapfel, Boris Michael
Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title_full Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title_fullStr Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title_full_unstemmed Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title_short Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
title_sort revision arthroplasty through the direct anterior approach using an asymmetric acetabular component
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564155/
https://www.ncbi.nlm.nih.gov/pubmed/32967075
http://dx.doi.org/10.3390/jcm9093031
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