Prosthesis survival after total hip arthroplasty - does surgical approach matter? Analysis of 19,304 Charnley and 6,002 Exeter primary total hip arthroplasties reported to the Norwegian Arthroplasty Register
Source: Acta Orthopaedica, Volume 78, Number 6, December 2007 , pp. 719-729(11)
Publisher: Informa Healthcare
Abstract:Background and purpose Controversies still exist about whether there is any effect of operative approach on survival of hip prostheses. We compared long-term survival of primary total hip arthroplasties in a welldefined study population from a national prospective population-based registry with regard to the three most commonly used surgical approaches. Methods We assessed prosthesis survival according to surgical approach (the lateral with or without trochanteric osteotomy, and the posterolateral) for 19,304 Charnley and 6,002 Exeter total hip arthroplasties performed from 1987 to 2004. Results For Charnley total hip arthroplasties, lateral approach with trochanteric osteotomy had a lower probability of revision than lateral approach without trochanteric osteotomy (RR = 0.6, 95% CI: 0.5-0.8). The lower revision rate was due to fewer revisions for aseptic loosening and dislocation. The differences had declined in the latest time period (1995-2004). We observed no differences between lateral approach without trochanteric osteotomy and posterolateral approach, except that there were more revisions due to dislocation in the posterolateral approach group (RR = 1.9, 95%CI: 1.1-3.2). No statistically significant differences were observed for Exeter total hip arthroplasties. Interpretation For Charnley prostheses, the lateral approach with trochanteric osteotomy gave a reduced revision risk compared to the other approaches, which was due to fewer revisions for dislocation, and in the first time period also fewer revisions due to aseptic loosening.
Document Type: Research Article
Affiliations: 1: Department of Orthopedic Surgery, Stavanger University Hospital, Stavanger 2: The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen,Department of the Surgical Sciences, University of Bergen, Norway 3: The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen 4: Department of General Surgery, Stavanger University Hospital, Stavanger,Department of the Surgical Sciences, University of Bergen, Norway
Publication date: December 2007