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

  • Symposium: Papers Presented at the Hip Society Meetings
  • Published:
Clinical Orthopaedics and Related Research®

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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Acknowledgment

We thank Crystal Mills, Coordinator for Slocum Research & Education Foundation, for her efforts in support of the project and manuscript.

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Authors and Affiliations

  1. Slocum Orthopedic Center, 55 Coburg Road, Eugene, OR, 97401, USA

    Brian A. Jewett MD & Dennis K. Collis MD

Authors
  1. Brian A. Jewett MD
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  2. Dennis K. Collis MD
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Corresponding author

Correspondence to Brian A. Jewett MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Jewett, B.A., Collis, D.K. High Complication Rate With Anterior Total Hip Arthroplasties on a Fracture Table. Clin Orthop Relat Res 469, 503–507 (2011). https://doi.org/10.1007/s11999-010-1568-1

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  • DOI: https://doi.org/10.1007/s11999-010-1568-1

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