Implant Survival After Minimally Invasive Anterior or Anterolateral Vs. Conventional Posterior or Direct Lateral Approach: An Analysis of 21,860 Total Hip Arthroplasties from the Norwegian Arthroplasty Register (2008 to 2013)

The Journal of Bone and Joint Surgery. American Volume
Knut Erik MjaalandLars Nordsletten

Abstract

Since 2008, there has been an increase in the use of minimally invasive surgery (MIS) through an anterior or anterolateral approach for total hip arthroplasty (THA) in Norway. We compared the MIS approaches with the conventional posterior and direct lateral approaches in terms of revision rates and risk of revision. On the basis of data in the Norwegian Arthroplasty Register, 21,860 THAs with an uncemented stem, performed between 2008 and 2013, were identified and included in the cohort. Of these THAs, 2,017 were done through an MIS anterior approach; 2,087, through an MIS anterolateral approach; 5,961, through a posterior approach; and 11,795, through a direct lateral approach. Follow-up ended on December 31, 2015. Two and 5-year survival rates were calculated using Kaplan-Meier survival analysis. Relative risk (RR) was calculated using Cox regression analysis, with adjustment for age, sex, primary diagnosis, American Society of Anesthesiologists (ASA) grade, femoral head size, cup fixation, type of articulation, and duration of surgery and using 6 revision end points based on cause: any cause, infection, dislocation, femoral fracture, aseptic loosening, and other/unknown cause. The median duration of follow-up was 4.3 years. ...Continue Reading

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Feb 17, 2018·Acta Orthopaedica·Larry E MillerSamir Bhattacharyya
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