Orthopedics. 2022 Mar-Apr;45(2):e79-e85. doi: 10.3928/01477447-20211227-07. Epub 2022 Jan 3.
Lateral trochanteric pain (LTP) is a common complication after total hip arthroplasty (THA). The goals of this study were to report the incidence of LTP after direct anterior approach (DAA) THA, describe the treatment course and outcomes, and examine patient-specific and implant-related potential risk factors. A retrospective review identified patients who underwent primary DAA THA with at least 1-year follow-up. Postoperative functional outcome scores and LTP occurrence were recorded. Patient demographics, surgical indications, implant characteristics, medical comorbidities, and radiographic parameters were obtained. Logistic regression analysis was used to identify risk factors. A total of 610 THA procedures were performed for 563 patients (mean follow-up, 30.9±15.2 months). The overall incidence of LTP was 11.6%. All cases of LTP were successfully treated conservatively, although these patients, compared with patients who did not have postoperative LTP, experienced significantly lower functional outcome scores (Harris Hip Score, 96.6±4.7 [range, 55-100] vs 89.9±8.5 [range, 42-100], respectively; <.001). Logistic regression analysis identified female sex (odds ratio, 2.30; 95% CI, 1.32-4.02), diabetes mellitus (odds ratio, 2.32; 95% CI, 1.11-4.88), hypertension (odds ratio, 1.94; 95% CI, 1.15-3.28), and the use of an offset acetabular liner (odds ratio, 2.50; 95% CI, 1.06-5.91) as independent risk factors for LTP. There was no correlation between LTP and radiographic parameters. The incidence of LTP after DAA THA is similar to reported rates for other THA surgical approaches. Female sex, medical comorbidities, and the use of offset acetabular liners are likely associated, and patients should be counseled appropriately. Postoperative LTP results in worse functional outcomes, although all cases can be treated conservatively. [. 2022;45(2):e79-e85.].
外侧转子间疼痛(LTP)是全髋关节置换术(THA)后的常见并发症。本研究的目的是报告直接前入路(DAA)THA 后 LTP 的发生率,描述治疗过程和结果,并检查患者特异性和植入物相关的潜在危险因素。回顾性分析确定了接受初次 DAA THA 且至少随访 1 年的患者。记录术后功能结果评分和 LTP 的发生情况。获取患者人口统计学、手术适应证、植入物特征、合并症和影像学参数。采用 logistic 回归分析确定危险因素。共对 563 例患者的 610 例 THA 手术进行了回顾性分析(平均随访 30.9±15.2 个月)。LTP 的总发生率为 11.6%。所有 LTP 病例均经保守治疗成功治愈,尽管与术后未发生 LTP 的患者相比,这些患者的功能结果评分明显较低(Harris 髋关节评分,96.6±4.7[范围,55-100]比 89.9±8.5[范围,42-100],<.001)。logistic 回归分析确定女性(比值比,2.30;95%置信区间,1.32-4.02)、糖尿病(比值比,2.32;95%置信区间,1.11-4.88)、高血压(比值比,1.94;95%置信区间,1.15-3.28)和使用偏心髋臼衬垫(比值比,2.50;95%置信区间,1.06-5.91)是 LTP 的独立危险因素。LTP 与影像学参数之间无相关性。DAA THA 后 LTP 的发生率与其他 THA 手术方法的报告率相似。女性、合并症和使用偏心髋臼衬垫可能与之相关,应适当对患者进行咨询。尽管所有病例都可以保守治疗,但术后 LTP 会导致功能结果更差。[. 2022;45(2):e79-e85.].