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Updated: Jan 15, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Complication Rates for Direct Anterior Total Hip Arthroplasty After Fellowship Compared with Switching Approaches
Justin A Magnuson1, Ilda B Molloy1, James Messina2
1The Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract:
The rate of complications and case complexity were evaluated in the first 100 total hip arthroplasty (THA) procedures in early-career direct anterior approach (DAA)-trained adult-reconstruction surgeons and midcareer surgeons who switched to DAA from a different approach. The study is a multicenter, retrospective analysis that collected data on 500 DAA THAs performed by three early-career surgeons and two midcareer surgeons. The patients of early-career surgeons were older (66.4 vs. 64.1), had a higher body mass index (29.9 vs. 28.4), and increased Charlson Comorbidity Index (2.21 vs. 1.52) compared with midcareer surgeons (p < 0.05). There were no differences in intraoperative complications or 90-day postoperative adverse events (odds ratio 0.45, 95% confidence interval 0.17 - 1.09, p = 0.87). Operative time was significantly greater for the early-career cohort relative to midcareer surgeons (98.1 min vs. 73.8 min, respectively, p < 0.001). Early-career fellowship-trained arthroplasty surgeons have similar complication rates to experienced surgeons switching from a different approach, with higher complexity patients. (Journal of Surgical Orthopaedic Advances 34(3):138-141, 2025).
