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Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate?

Publication ,  Journal Article
Schweppe, ML; Seyler, TM; Plate, JF; Swenson, RD; Lang, JE
Published in: Surg Technol Int
September 2013

There is a substantial preoccupation with different surgical approaches and minimally invasive techniques that may improve clinical outcomes for patients who undergo total hip arthroplasty. This study assessed the impact on hospital-related outcomes of the direct anterior approach (DAA) compared with the posterior approach (PA) performed by a single surgeon in 100 consecutive patients in each cohort. Patient age was similar in the DAA (61 ± 1.1 years) compared with the PA (62 ± 1.3, p = 0.733); however, BMI tended to be lower in DAA patients (29.1 ± 0.8) compared with PA patients (31.3 ± 0.7, p = 0.057). The DAA compared with the PA was associated with significantly less blood loss (285 ± 15 vs. 367 ± 21ml, p = 0.002) and transfusions (18 vs. 39 units, p = 0.009), less narcotic usage on postoperative days 1-3 (101 ± 12 vs. 146 ± 12 morphine equivalent dose, p = 0.010), a quicker hospital discharge (70 ± 3.3 vs. 97 ± 5.5 hours, p < 0.001), and a more favorable disposition (97% vs. 84% discharged home, p = 0.003). Thirty-day readmission rate was significantly higher with the PA (9%) compared with the DAA (1%, p = 0.030). The number of cups in the safe zone (5° to 25° anteversion and 30° to 50° inclination) was significantly higher with the DAA (92%) compared with the PA (75%, p = 0.002), possibly attributed to fluoroscopy used with the DAA. The DAA muscle-preservation technique may have led to the benefits observed in this study compared with the muscle-splitting technique associated with the PA.

Duke Scholars

Published In

Surg Technol Int

ISSN

1090-3941

Publication Date

September 2013

Volume

23

Start / End Page

219 / 227

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Rehabilitation
  • Recovery of Function
  • Prevalence
  • Patient Readmission
  • Patient Discharge
  • North Carolina
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schweppe, M. L., Seyler, T. M., Plate, J. F., Swenson, R. D., & Lang, J. E. (2013). Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate? Surg Technol Int, 23, 219–227.
Schweppe, Mark L., Thorsten M. Seyler, Johannes F. Plate, Richard D. Swenson, and Jason E. Lang. “Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate?Surg Technol Int 23 (September 2013): 219–27.
Schweppe ML, Seyler TM, Plate JF, Swenson RD, Lang JE. Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate? Surg Technol Int. 2013 Sep;23:219–27.
Schweppe, Mark L., et al. “Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate?Surg Technol Int, vol. 23, Sept. 2013, pp. 219–27.
Schweppe ML, Seyler TM, Plate JF, Swenson RD, Lang JE. Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate? Surg Technol Int. 2013 Sep;23:219–227.

Published In

Surg Technol Int

ISSN

1090-3941

Publication Date

September 2013

Volume

23

Start / End Page

219 / 227

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Rehabilitation
  • Recovery of Function
  • Prevalence
  • Patient Readmission
  • Patient Discharge
  • North Carolina