Post-operative clinical outcomes and complications of posterior versus lateral approach for primary total hip arthroplasty: A retrospective cohort study

Abstract

Objectives: Total hip arthroplasty (THA) is considered one of the therapeutic procedures frequently performed in orthopedic surgery. It is believed that the surgical approach could influence the clinical outcomes following THA. We performed a retrospective cohort study to compare the postoperative clinical outcomes and complications between the posterior approach (PA) and the lateral approach (LA) for primary THA. Methods: We enrolled patients who underwent primary THA through PA or LA. We sought to evaluate the postoperative complications including the need for intra- or postoperative blood transfusion, dislocation rate, and venous thromboembolism events, and the clinical outcomes, including length of hospital stay, operative time, and perioperative blood loss. Results: A total of 211 patients (71 patients in PA vs. 140 patients in LA) were deemed eligible to be included in this study. There was no significant difference between PA and LA in post-operative clinical outcomes concerning operative time, and perioperative blood loss except for the length of hospital stay (PA median = 6.0 days vs. LA median = 9.0 days; P < 0.001) patients. After adjustment for the potential confounders, the length of hospital stay was found to be similar between the two groups (P = 0.06). Similarly, no difference was found between PA and LA in post-operative complications concerning the need for intra-operative blood transfusion, dislocation rate, and venous thromboembolism events except for the need for postoperative blood transfusion (RR = 1.82, 95% CI 1.16–2.87), which continued to be significantly higher in PA even after adjustment for the potential confounders (P ≤ 0.01). Conclusion: PA and LA herald similar outcomes for patients undergoing primary THA concerning the postoperative clinical outcomes and complications except for the need for post-operative blood transfusion.