Risk Factors for Lateral Trochanteric Pain Following Anterior Approach Total Hip Arthroplasty
Rex W Lutz1, Danielle Y Ponzio2, Hope S Thalody2
1Jefferson Health New Jersey, Stratford, NJ, USA.
The Archives of Bone and Joint Surgery
|November 5, 2024
Summary
Smoking history and increased femoral and total offset are linked to lateral trochanteric pain (LTP) following direct anterior approach (DAA) primary total hip arthroplasty (THA). These findings aid in understanding and potentially preventing LTP after hip replacement surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Rehabilitative Medicine
Background:
- Lateral trochanteric pain (LTP) is a potential complication following total hip arthroplasty (THA).
- The direct anterior approach (DAA) is a surgical technique used for primary THA.
- Identifying risk factors for LTP is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate risk factors associated with lateral trochanteric pain (LTP) after direct anterior approach (DAA) primary total hip arthroplasty (THA).
Main Methods:
- A retrospective case-control study involving 542 patients who underwent primary THA.
- Two matched cohorts were formed: 271 patients with LTP and 271 controls.
- Data collected included demographics, surgical approach, femoral components, and radiographic measurements of limb length and offset.
Main Results:
- A higher proportion of current or former smokers were observed in the LTP group (34.5% vs 21.74%, p=0.003).
- The LTP group showed a significantly greater increase in femoral offset (+3.55mm vs +1.79mm, p<0.001) and total offset (+0.16mm vs -1.16mm, p=0.031) compared to controls.
- No significant difference was found in the use of high-offset vs. standard-offset stems between the groups.
Conclusions:
- Increased total offset, increased femoral offset, and a history of smoking are identified as factors associated with LTP after DAA primary THA.
- These findings suggest potential modifiable risk factors that may help in the prevention of LTP.
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