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Total hip arthroplasty through the direct anterior approach in morbidly obese patients

AIMS: There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complica...

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Autores principales: Argyrou, Chrysoula, Tzefronis, Dimitrios, Sarantis, Michail, Kateros, Konstantinos, Poultsides, Lazaros, Macheras, George A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2022
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047080/
https://www.ncbi.nlm.nih.gov/pubmed/34985307
http://dx.doi.org/10.1302/2633-1462.31.BJO-2021-0166.R1
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author Argyrou, Chrysoula
Tzefronis, Dimitrios
Sarantis, Michail
Kateros, Konstantinos
Poultsides, Lazaros
Macheras, George A.
author_facet Argyrou, Chrysoula
Tzefronis, Dimitrios
Sarantis, Michail
Kateros, Konstantinos
Poultsides, Lazaros
Macheras, George A.
author_sort Argyrou, Chrysoula
collection PubMed
description AIMS: There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complications and outcomes of morbidly obese patients with nonobese patients. METHODS: Morbidly obese patients (n = 86), with BMI ≥ 40 kg/m(2) who underwent DAA THA at our institution between September 2010 and December 2017, were matched to 172 patients with BMI < 30 kg/m(2). Data regarding demographics, set-up and operating time, blood loss, radiological assessment, Harris Hip Score (HHS), International Hip Outcome Tool (12-items), reoperation rate, and complications at two years postoperatively were retrospectively analyzed. RESULTS: No significant differences in blood loss, intra- and postoperative complications, or implant position were observed between the two groups. Superficial wound infection rate was higher in the obese group (8.1%) compared to the nonobese group (1.2%) (p = 0.007) and relative risk of reoperation was 2.59 (95% confidence interval 0.68 to 9.91). One periprosthetic joint infection was reported in the obese group. Set-up time in the operating table and mean operating time were higher in morbidly obese patients. Functional outcomes and patient-related outcome measurements were superior in the obese group (mean increase of HHS was 52.19 (SD 5.95) vs 45.1 (SD 4.42); p < 0.001), and mean increase of International Hip Outcome Tool (12-items) was 56.8 (SD 8.88) versus 55.2 (SD 5.85); p = 0.041). CONCLUSION: Our results suggest that THA in morbidly obese patients can be safely and effectively performed via the DAA by experienced surgeons. Cite this article: Bone Jt Open 2022;3(1):4–11.
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spelling pubmed-90470802022-04-29 Total hip arthroplasty through the direct anterior approach in morbidly obese patients Argyrou, Chrysoula Tzefronis, Dimitrios Sarantis, Michail Kateros, Konstantinos Poultsides, Lazaros Macheras, George A. Bone Jt Open Hip AIMS: There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complications and outcomes of morbidly obese patients with nonobese patients. METHODS: Morbidly obese patients (n = 86), with BMI ≥ 40 kg/m(2) who underwent DAA THA at our institution between September 2010 and December 2017, were matched to 172 patients with BMI < 30 kg/m(2). Data regarding demographics, set-up and operating time, blood loss, radiological assessment, Harris Hip Score (HHS), International Hip Outcome Tool (12-items), reoperation rate, and complications at two years postoperatively were retrospectively analyzed. RESULTS: No significant differences in blood loss, intra- and postoperative complications, or implant position were observed between the two groups. Superficial wound infection rate was higher in the obese group (8.1%) compared to the nonobese group (1.2%) (p = 0.007) and relative risk of reoperation was 2.59 (95% confidence interval 0.68 to 9.91). One periprosthetic joint infection was reported in the obese group. Set-up time in the operating table and mean operating time were higher in morbidly obese patients. Functional outcomes and patient-related outcome measurements were superior in the obese group (mean increase of HHS was 52.19 (SD 5.95) vs 45.1 (SD 4.42); p < 0.001), and mean increase of International Hip Outcome Tool (12-items) was 56.8 (SD 8.88) versus 55.2 (SD 5.85); p = 0.041). CONCLUSION: Our results suggest that THA in morbidly obese patients can be safely and effectively performed via the DAA by experienced surgeons. Cite this article: Bone Jt Open 2022;3(1):4–11. The British Editorial Society of Bone & Joint Surgery 2022-01-05 /pmc/articles/PMC9047080/ /pubmed/34985307 http://dx.doi.org/10.1302/2633-1462.31.BJO-2021-0166.R1 Text en © 2022 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Hip
Argyrou, Chrysoula
Tzefronis, Dimitrios
Sarantis, Michail
Kateros, Konstantinos
Poultsides, Lazaros
Macheras, George A.
Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title_full Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title_fullStr Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title_full_unstemmed Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title_short Total hip arthroplasty through the direct anterior approach in morbidly obese patients
title_sort total hip arthroplasty through the direct anterior approach in morbidly obese patients
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047080/
https://www.ncbi.nlm.nih.gov/pubmed/34985307
http://dx.doi.org/10.1302/2633-1462.31.BJO-2021-0166.R1
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