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Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review

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Abstract

Purpose

To investigate the prevalence of heterotopic ossification following direct anterior approach total hip arthroplasty compared to posterior approach, performed by a single surgeon at one institution

Methods

All primary THAs performed by the senior author (JEL) over a 70-month period were reviewed, including 235 DAA and 120 posterior THAs. Brooker’s system was used to grade HO at a minimum of six months follow-up.

Results

Patients undergoing DAA were less likely to develop clinically significant HO compared to posterior THA (p = 0.04). The overall incidence of HO following DAA THA was 24.3 % (3 % grade 3 and 0 % grade 4), and following posterior THA was 27.5 % (4.2 % grade 3 and 3.3 % grade 4).

Conclusions

Lower rates of clinically significant (Brooker grade 3 and 4) HO were observed in DAA THA than in posterior approach THA. This data may be instructive when approaching THA candidates with conditions that predispose them to HO.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston–Salem, NC, 27157, USA

    Elizabeth A. Newman, David C. Holst, Daniel N. Bracey & Jason E. Lang

  2. Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston–Salem, NC, 27157, USA

    Gregory B. Russell

Authors
  1. Elizabeth A. Newman
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  2. David C. Holst
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  3. Daniel N. Bracey
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  4. Gregory B. Russell
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  5. Jason E. Lang
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Corresponding author

Correspondence to Jason E. Lang.

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Funding

No external funding sources were used in the completion of this project

Conflict of interest

The authors have no relevant conflict of interest with regard to this study to declare.

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Newman, E.A., Holst, D.C., Bracey, D.N. et al. Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review. International Orthopaedics (SICOT) 40, 1967–1973 (2016). https://doi.org/10.1007/s00264-015-3048-4

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  • DOI: https://doi.org/10.1007/s00264-015-3048-4

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