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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2011

01-02-2011 | Symposium: Papers Presented at the Hip Society Meetings

High Complication Rate With Anterior Total Hip Arthroplasties on a Fracture Table

Authors: Brian A. Jewett, MD, Dennis K. Collis, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2011

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Abstract

Background

Recent attention in THA has focused on minimally invasive techniques and their short-term outcomes. Despite much debate over the outcomes and complications of the two-incision and the mini-lateral and mini-posterior approaches, complications arising from use of the anterior THA on a fracture table are not well documented.

Questions/purposes

We determined the intraoperative and postoperative complications with the anterior approach to THA through an extended single-surgeon patient series.

Methods

We reviewed 800 primary THAs performed anteriorly with the aid of a fracture table over 5 years and recorded all intraoperative and postoperative complications up to latest followup (average, 1.8 years; range, 0–5 years). Patients with severe acetabular deformity or severe flexion contractures were excluded and those surgeries were performed with a lateral approach during the time period of this study.

Results

Intraoperative complications included 19 trochanteric fractures, three femoral perforations, one femoral fracture, one acetabular fracture, one bleeding complication, and one case of cardiovascular collapse. There were no ankle fractures. Postoperative complications included seven patients with dislocations; seven with deep infections; one with delayed femur fracture; 37 with wound complications, among which 13 had reoperation for local débridement; 14 with deep venous thrombosis; and two with pulmonary embolism; and 31 other nonfatal medical complications.

Conclusions

The main intraoperative complications of trochanteric fractures and perforations occurred mostly early in the series, while the main postoperative complications related to wound healing were prevalent throughout the entire series. Despite potential advantages of use of a fracture table, surgeons should be aware of the potential complications of trochanteric fractures, perforations, and wound-healing problems associated with this technique.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
High Complication Rate With Anterior Total Hip Arthroplasties on a Fracture Table
Authors
Brian A. Jewett, MD
Dennis K. Collis, MD
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1568-1

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