دورية أكاديمية
Surgical Approach and Body Mass Index Impact Risk of Wound Complications Following Total Hip Arthroplasty.
| العنوان: | Surgical Approach and Body Mass Index Impact Risk of Wound Complications Following Total Hip Arthroplasty. |
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| المؤلفون: | Salmons HI; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Larson DR; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota., Couch CG; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Bingham JS; Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona., Ledford CK; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida., Trousdale RT; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Taunton MJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Wyles CC; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota. |
| المصدر: | The Journal of arthroplasty [J Arthroplasty] 2024 Mar 26. Date of Electronic Publication: 2024 Mar 26. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New Brunswick, NJ : Taylor and Francis Original Publication: [New York, NY : Churchill Livingstone, c1986- |
| مستخلص: | Background: Previous studies have suggested that wound complications may differ by surgical approach after total hip arthroplasty (THA), with particular attention toward the direct anterior approach (DAA). However, there is a paucity of data documenting wound complication rates by surgical approach and the impact of concomitant patient factors, namely body mass index (BMI). This investigation sought to determine the rates of wound complications by surgical approach and identify BMI thresholds that portend differential risk. Methods: This multicenter study retrospectively evaluated all primary THA patients from 2010 to 2023. Patients were classified by skin incision as having a laterally based approach (posterior or lateral approach) or DAA (longitudinal incision). We identified 17,111 patients who had 11,585 laterally based (68%) and 5,526 (32%) DAA THAs. The mean age was 65 years (range, 18 to 100), 8,945 patients (52%) were women, and the mean BMI was 30 (range, 14 to 79). Logistic regression and cut-point analyses were performed to identify an optimal BMI cutoff, overall and by approach, with respect to the risk of wound complications at 90 days. Results: The 90-day risk of wound complications was higher in the DAA group versus the laterally based group, with an absolute risk of 3.6% versus 2.6% and a multivariable adjusted odds ratio of 1.5 (P < .001). Cut-point analyses demonstrated that the risk of wound complications increased steadily for both approaches, but most markedly above a BMI of 33. Conclusions: Wound complications were higher after longitudinal incision DAA THA compared to laterally based approaches, with a 1% higher absolute risk and an adjusted odds ratio of 1.5. Furthermore, BMI was an independent risk factor for wound complications regardless of surgical approach, with an optimal cut-point BMI of 33 for both approaches. These data can be used by surgeons to help consider the risks and benefits of approach selection. Level of Evidence: Level III. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Total hip arthroplasty; complications; habitus; obesity; outcomes |
| تواريخ الأحداث: | Date Created: 20240328 Latest Revision: 20240422 |
| رمز التحديث: | 20240423 |
| DOI: | 10.1016/j.arth.2024.03.047 |
| PMID: | 38548235 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-8406 |
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| DOI: | 10.1016/j.arth.2024.03.047 |