Risk of infection in primary, elective total hip arthroplasty with direct anterior approach or lateral transgluteal approach: a prospective cohort study of 1104 hips

BMC Musculoskeletal Disorders

Research Article

Lilianna Bolliger¹  Peter Graber²  Werner Zimmerli²  Martin Clauss³  Thomas Ilchmann⁴ 

[1] Department for Orthopedics and Trauma Surgery, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland;Interdisciplinary Unit for Orthopedic Infections, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland;Interdisciplinary Unit for Orthopedic Infections, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland;Department for Orthopedics and Trauma Surgery, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland;Interdisciplinary Unit for Orthopedic Infections, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland;Leonardo, Hirslanden Klinik Birshof, Reinacherstrasse 28, 4142, Münchenstein, Switzerland;

关键词: PJI;    Direct anterior approach;    Lateral transgluteal approach;    Total hip arthroplasty;    Prosthetic joint infection;   

DOI  :  10.1186/s12891-016-1332-0

 received in 2016-06-14, accepted in 2016-11-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe direct anterior approach (DAA) is increasingly popular for hip replacement. However, the small incision and the location near to the groin might increase the risk of periprosthetic joint infection (PJI). We asked the questions (i) whether there is an increased risk of infection for this approach, and (ii) whether the spectrum of microorganisms differs between patients with DAA and those with lateral transgluteal approach (LAT).MethodsAll patients operated between 08/2006 and 12/2013 were followed prospectively in an in house register. The DAA was introduced as routine in 02/2009 at our hospital. Patients with primary elective hip replacement without previous operations were included. Follow-up was scheduled after 6, 12 weeks and 1, 2 years. PJI was defined according to standardized criteria.ResultsOne thousand one hundred four patients were studied, 700 were operated with DAA and 404 with LAT. No patient was lost to follow-up. PJI was diagnosed in 23/1104 (2.1 %) patients, 16 (2.3 %) in the group with DAA, and 7 (1.7 %) in the group with LAT. Patients with infection had a higher BMI (p < 0.001) and a higher ASA score (p < 0.001). Only patients with the DAA had exogenous PJI caused by gramnegative bacilli (35.7 % vs 0 %, p = 0.26). In the DAA-group, the fraction of patients with polymicrobial infection was somewhat higher than in the LAT-group (50 % vs 33 %, P = 0.64).ConclusionThere was no increased risk of infection for the DAA.

【 授权许可】

CC BY   
© The Author(s). 2016