1. The Influence of Body Mass Index and Hip Anatomy on Direct Anterior Approach Total Hip Replacement
- Author
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Haiming Lu, Weilin Sang, Jinzhong Ma, Libo Zhu, and Cong Wang
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,China ,Bleeding Time ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Operative Time ,MEDLINE ,Total hip replacement ,Hip replacement (animal) ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Medicine ,Humans ,Femur ,Obesity ,Aged ,Retrospective Studies ,Aged, 80 and over ,030222 orthopedics ,Original Paper ,business.industry ,Retrospective cohort study ,030229 sport sciences ,General Medicine ,Anatomy ,Middle Aged ,Hip replacement ,Arthroplasty ,Surgery ,Direct anterior approach ,Operative time ,Female ,Hip Joint ,Anterior approach ,business ,Body mass index - Abstract
Objective: To investigate the influence of body mass index (BMI) and hip anatomy on direct anterior approach (DAA) total hip replacement. Subjects and Methods: The study is a retrospective analysis of 124 cases of DAA total hip replacement from 2009 to 2012. The BMI, the ratio of the greater trochanter (GT) and anterior superior iliac spine (ASIS) bilaterally (GT/ASIS), and the vertical distance between the ASIS and GT (AGVD) were obtained from medical records. All cases were categorized into three groups (43, 49, and 32 cases in each group, respectively) based on BMI (BMI 25) or divided into two groups based on GT/ASIS (≤1.17 or >1.17) or AGVD (≤86 or >86 mm). Operating time, intraoperative bleeding, and surgical complications were compared between different groups. Results: A longer average operating time, more intraoperative bleeding, and a higher rate of complications were observed in the group with the highest BMI. The complications included a case of intraoperative femur fracture, a wound hematoma, and a lateral femoral cutaneous nerve injury. The group with higher GT/ASIS had a shorter average operating time, less bleeding, and a lower complication rate than the group with lower GT/ASIS. Moreover, the group with higher AGVD showed a shorter average operating time, less bleeding, and a lower complication rate compared with the group with lower AGVD. Conclusion: Our study suggests that lower BMI and larger GT/ASIS and AGVD are associated with a shorter operating time, less bleeding, and a lower complication rate in DAA total hip replacement. These findings are valuable for clinicians to make the appropriate choice of surgery types for different individuals.
- Published
- 2016