前侧入路髋关节翻修术与后侧入路髋关节翻修术相比，前者的切口并发症更高，但脱位率更低。
Anterior Revision Hip Arthroplasty is Associated With Higher Wound Complications but Fewer Dislocations Compared to Posterior Revision Hip Surgery.
机构信息
Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA.
出版信息
J Arthroplasty. 2021 Jan;36(1):250-254. doi: 10.1016/j.arth.2020.07.030. Epub 2020 Jul 18.
BACKGROUND
Wound complication after primary direct anterior (DAA) hip arthroplasty has been reported in the literature but there has been no comparison regarding revision anterior vs revision posterior (PA) hip arthroplasty. The authors hypothesize that anterior approach revision surgery may have increased wound complications compared with posterior hip revisions and also report on secondary outcome metrics.
METHODS
Ninety-nine DAA and 191 PA revisions were included for analysis. Preoperative demographic characteristics, indication for revision, operative details, type of revision performed, components utilized, and postoperative complications were compared between DAA and PA groups including multivariate analysis.
RESULTS
The DAA cohort demonstrated an increased risk of superficial wound complications (7.1% vs 0.5%, P = .003) and a decreased dislocation rate (2.0% vs 13.1%, P = .002). There was a trend toward increased overall complications in the PA group (OR 1.71, P = .078).
CONCLUSION
Revision DAA THA is associated with an increased risk of superficial wound complications, but may impart a decreased dislocation rate.
背景
文献中报道了初次直接前侧（DAA）髋关节置换术后的伤口并发症，但对于前路翻修与后路翻修（PA）髋关节置换术的比较尚未见报道。作者假设与后路髋关节翻修相比，前路入路翻修手术可能会增加伤口并发症，并报告次要结果指标。
方法
共纳入 99 例 DAA 翻修和 191 例 PA 翻修进行分析。比较 DAA 和 PA 组之间的术前人口统计学特征、翻修指征、手术细节、进行的翻修类型、使用的组件以及术后并发症，包括多变量分析。
结果
DAA 组的浅表伤口并发症风险增加（7.1%比 0.5%，P =.003），脱位率降低（2.0%比 13.1%，P =.002）。PA 组的总体并发症发生率呈增加趋势（OR 1.71，P =.078）。
结论
DAA-THA 翻修与浅表伤口并发症风险增加相关，但可能降低脱位率。
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