Is the Direct Anterior Approach for Total Hip Arthroplasty Effective in Obese Patients? Early Clinical and Radiographic Results from a Retrospective Comparative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Surgical Technique
2.2. Post-Operative Care
2.3. Radiological Evaluation
2.4. Statistical Analysis
3. Results
3.1. Patients’ Demographics and Characteristics
3.2. Radiographic Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviation
THA | Total hip arthroplasty |
DAA | Direct Anterior Approach |
BMI | Body Mass Index |
NW | Normal weight patients |
OW | Overweight patients |
OB | Obese patients |
ASA | American Society of Anesthesiologists |
NRS | Numerical Rating Scale |
References
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Patients Characteristics | NW (n = 96) | OW (n = 115) | OB (n = 82) |
---|---|---|---|
Age (Years) | 63.3 (34–86 years) | 63.9 (34–86 years) | 58.6 (36–83 years) |
Sex (M/F) | 43% M/57% F (41 M 55 F) | 60% M/40% F (69 M 46 F) | 56% M/44% F (46 M 36 F) |
ASA I | 39% (37) | 23% (26) | 16% (13) |
ASA II | 47% (45) | 62% (71) | 63% (52) |
ASA III | 14% (14) | 15% (18) | 21% (17) |
Complications | NW | OW | OB | Total |
---|---|---|---|---|
Wound dehiscence | - | - | 1/82 (1.22%) | 1/293 (0.34%) |
Intra-operative femur fracture | 1/96 (1.04%) | 1/115 (0.87%) | - | 2/293 (0.68%) |
Dislocation | - | - | 2/82 (2.43%) | 2/293 (0.68%) |
Aseptic loosening | 1/96 (1.04%) | - | 1/82 (1.22%) | 2/293 (0.68%) |
Total | 2/96 (2.08%) | 1/115 (0.87%) | 4/82 (4.87%) | 7/293 (2.3%) |
NW | OW | OB | ||
---|---|---|---|---|
NRS at 2nd post-operative day | 1.2 ± 1.0 | 1.3 ± 1.1 | 1.5 ± 1.0 | p = 0.346 |
Day of post-operative stair climbing | 3.4 ± 1.7 | 3.5 ± 1.9 | 3.7 ± 1.7 | p = 0.456 |
NW | OW | OB | Total | |
---|---|---|---|---|
Within Lewinnek’s safe zone | 74 (77.1%) | 86 (74.8%) | 62 (75.6%) | 222 (75.8%) |
Out of Lewinnek’s safe zone | 22 (22.9%) | 29 (25.2%) | 20 (24.4%) | 71 (24.2%) |
Total | 96 | 115 | 82 | 293 |
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Di Martino, A.; Stefanini, N.; Brunello, M.; Bordini, B.; Pilla, F.; Geraci, G.; D’Agostino, C.; Ruta, F.; Faldini, C. Is the Direct Anterior Approach for Total Hip Arthroplasty Effective in Obese Patients? Early Clinical and Radiographic Results from a Retrospective Comparative Study. Medicina 2023, 59, 769. https://doi.org/10.3390/medicina59040769
Di Martino A, Stefanini N, Brunello M, Bordini B, Pilla F, Geraci G, D’Agostino C, Ruta F, Faldini C. Is the Direct Anterior Approach for Total Hip Arthroplasty Effective in Obese Patients? Early Clinical and Radiographic Results from a Retrospective Comparative Study. Medicina. 2023; 59(4):769. https://doi.org/10.3390/medicina59040769
Chicago/Turabian StyleDi Martino, Alberto, Niccolò Stefanini, Matteo Brunello, Barbara Bordini, Federico Pilla, Giuseppe Geraci, Claudio D’Agostino, Federico Ruta, and Cesare Faldini. 2023. "Is the Direct Anterior Approach for Total Hip Arthroplasty Effective in Obese Patients? Early Clinical and Radiographic Results from a Retrospective Comparative Study" Medicina 59, no. 4: 769. https://doi.org/10.3390/medicina59040769