Effect of Surgical Approach on Length of Stay, Cost, and Early Complication Rate in Total Hip Arthroplasty

摘要

Total hip arthroplasty (THA) is a historically popular and successful operation. While many steps of the operation are consistent between practitioners, discussion around which approach constitutes the “best” approach for routine, primary THA remains an open question. Objective?The purpose of this study was to determine the effects of the surgical approach on hospital length of stay (LOS), hospital costs, and complication rates. A multisurgeon review of a single hospital was conducted to evaluate three surgical approaches: superior (SA), posterior (PA), and direct anterior (DAA). Methods?All elective primary THAs performed between July 2013 and July 2016 were reviewed in an administrative database. Two surgeons performed SA, three surgeons performed PA, and two surgeons performed DAA. A total of 1,799 arthroplasties were analyzed: 980 (SA), 685 (PA), and 134 (DAA). Multivariate logistic, Poisson, and linear regression models were used to calculate the effects of each approach on LOS, cost, and per cent discharge home while adjusting for age, severity of illness scores, obesity, and smoking. Results?After adjusting for patient characteristics, mean LOS for SA (1.8 days) was lower than both PA (2.4, p?