Bialek Samantha, Oetojo William, Burnham Robert, Brown Nicholas
Loyola University Medical Center, Department of Orthopaedic Surgery & Rehabilitation, Maywood, IL, USA.
Arthroplast Today. 2025 Mar 26;33:101675. doi: 10.1016/j.artd.2025.101675. eCollection 2025 Jun.
Increased pannus size is a risk factor for complications with anterior approach total hip arthroplasty (THA). However, it is unclear if changing to a posterior approach mitigates this risk. The purpose of this study was to evaluate whether abdominal pannus size had a differential effect on complication rate comparing anterior vs posterior THA.
One thousand consecutive primary THA patients-478 anterior and 522 posterior-were retrospectively reviewed for complications and their abdominal pannus was radiographically measured on an anteroposterior pelvis image and placed into 1 of 4 categories based on its vertical size (no pannus [G0], above symphysis [G1], below symphysis [G2], or below ischial tuberosities [G3]). Chi-squared tests for univariate and logistic regression models controlled for age, race, gender, body mass index, Charlson comorbidity index, and smoking.
Comparing wound complications at increasing pannus size, anterior vs posterior (G0 1.9% vs 3.9%, = .21; G1 7.2% vs 6.7%, = .08; G2 17.9% vs 11.6%, = .27; G3 16.7% vs 15.5%, = .84), similar results were found with reoperations (G0 0.9% vs 1.1%, = .080; G1 1.4% vs 2%, = .72; G2 3.0% vs 5.8%, = .41; G3 1.7% vs 4.5%, = .33). Additionally, logistic regression models demonstrated no statistically significant difference in the odds of wound complications or reoperations between the approaches at each pannus size.
In patients with an abdominal pannus, there is no difference in the risk of delayed wound healing or reoperation within 90 postoperative days comparing anterior to posterior approach.
血管翳增大是前路全髋关节置换术（THA）并发症的一个危险因素。然而，改为后路手术是否能降低这种风险尚不清楚。本研究的目的是评估腹部血管翳大小在前路与后路THA中对并发症发生率是否有不同影响。
回顾性分析连续1000例初次THA患者——478例前路手术和522例后路手术——的并发症情况，并在骨盆前后位影像上对其腹部血管翳进行X线测量，根据其垂直大小分为4类之一（无血管翳[G0]、耻骨联合上方[G1]、耻骨联合下方[G2]或坐骨结节下方[G3]）。采用卡方检验进行单因素分析，并使用逻辑回归模型控制年龄、种族、性别、体重指数、Charlson合并症指数和吸烟情况。
比较不同血管翳大小情况下的伤口并发症，前路与后路相比（G0：1.9%对3.9%，P = 0.21；G1：7.2%对6.7%，P = 0.08；G2：17.9%对11.6%，P = 0.2），再次手术情况结果相似（G0：0.9%对1.1%，P = 0.080；G1：1.4%对2%，P = 0.72；G2：3.0%对5.8%，P = 0.41；G3：1.7%对4.5%，P = 0.33）。此外，逻辑回归模型显示，在每个血管翳大小类别中，两种手术方式在伤口并发症或再次手术几率方面无统计学显著差异。
对于有腹部血管翳的患者，术后90天内，前路与后路手术相比，伤口延迟愈合或再次手术的风险没有差异。
