Changing Surgical Approach Does Not Increase Dislocation Risk, Study Finds

For Immediate Release
November 14, 2021

Dallas – A presentation at the 2021 AAHKS Annual Meeting reported that changing the surgical approach from primary to revision Total Hip Arthroplasty (THA) does not increase risk of dislocation or revision. No prior studies have examined outcomes based on utilizing a concordant vs. discordant approach between the primary and revision THA.

Surgeons have many considerations that lead to preferred surgical approaches in revision THA. This study aimed to quantify surgical approach discordance from primary to revision THA, and assess the impact changing surgical approaches had on dislocation, re-revision, reoperation, and non-operative complication rates.

Lead author Joshua R. Harmer, MD, and co-authors Cody C. Wyles, MD, Dirk R. Larson, MS, Michael J. Taunton, MD, Mark W. Pagnano, MD, and Matthew P. Abdel, MD, reviewed almost 800 revision THAs. Surgical approach was determined as were dislocations, re-revisions, reoperations, and complications. Complication rates were compared between those with concordant and discordant surgical approaches.

Surgical approach discordance occurred in 106 cases (13%), which was more frequent when the direct anterior approach was used for primary THA compared to lateral (12%) or posterior (10%) approaches. There were no statistically significant differences in the incidence of dislocations, re-revisions, reoperations, and non-operative complications among those with concordant and discordant approaches. Among patients with a posterior approach during primary THA, there was a trend toward decreased dislocation risk with a revision lateral approach compared to posterior approach.

In conclusion, the comparable dislocation and complication rates observed among revision THAs with concordant and discordant approaches between primary and revision THA support that changing vs. maintaining the surgical approach from primary to revision THA does not significantly increase dislocation risk or that of re-revision, reoperations, and non-operative complications.

Abstract: https://meeting.aahks.org/wp-content/uploads/2021-FINAL-Printed-Program-Book-pages-76.pdf

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About the American Association of Hip and Knee Surgeons
Established in 1991, the mission of AAHKS is to advance hip and knee patient care through education and advocacy. AAHKS has a membership of over 4,000 surgeons and other hip and knee health care professionals.