Abstract
Introduction
The purpose of the study was to assess the clinical outcomes of an algorithm for soft tissue femoral release in anterior approach (AA) total hip arthroplasty (THA). Specifically, the following were assessed in this series of patients utilizing a standardized soft tissue release sequence: 1) clinical outcomes with the Harris Hip Score (HHS); 2) re-operation rates; 3) component survivorship; and 4) complications.
Methods
We retrospectively analyzed a prospectively maintained database of patients who underwent AA THA from 2014 to 2017. A total of 1000 patients were included, with minimum follow up of 2 years (range 2–5 years). The mean age was 65 years (range, 22–89), 48% were males, and the mean Body Mass Index was 34 (range, 20–52). Descriptive statistics were performed for most endpoints except for component survivorship, which was assessed with Kaplan-Meier analysis.
Result
There was 95% follow-up (54 patients lost to follow-up). The HHS improved from mean 56 preoperatively (range, 34–78) to mean 88 post-operatively (range, 65–100) (p<0.01). There were three complications: one superficial wound dehiscence which resolved with outpatient secondary operative wound closure; one calcar fracture managed non-operatively; and one anterior hip dislocation managed with closed reduction. There were no cases of component loosening, deep infection, prosthetic joint infection, or death. All components demonstrated survivorship.
Conclusion
Using an algorithmic AA THA technique to address the femoral soft tissue release may offer acceptable outcomes and complication rates. Further study of this technique is warranted utilizing data from multiple surgeons to ensure that findings in this study are generalizable.
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