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. 2016 Sep;40(9):1967-73.
doi: 10.1007/s00264-015-3048-4. Epub 2015 Nov 27.

Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review

Elizabeth A Newman  1 , David C Holst  1 , Daniel N Bracey  1 , Gregory B Russell  2 , Jason E Lang  3
Affiliations

Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review

Elizabeth A Newman et al. Int Orthop. 2016 Sep.

Abstract

Purpose: To investigate the prevalence of heterotopic ossification following direct anterior approach total hip arthroplasty compared to posterior approach, performed by a single surgeon at one institution

Methods: All primary THAs performed by the senior author (JEL) over a 70-month period were reviewed, including 235 DAA and 120 posterior THAs. Brooker's system was used to grade HO at a minimum of six months follow-up.

Results: Patients undergoing DAA were less likely to develop clinically significant HO compared to posterior THA (p = 0.04). The overall incidence of HO following DAA THA was 24.3 % (3 % grade 3 and 0 % grade 4), and following posterior THA was 27.5 % (4.2 % grade 3 and 3.3 % grade 4).

Conclusions: Lower rates of clinically significant (Brooker grade 3 and 4) HO were observed in DAA THA than in posterior approach THA. This data may be instructive when approaching THA candidates with conditions that predispose them to HO.

Keywords: Brooker classification; Direct anterior approach total hip; Heterotopic ossification; Posterior approach total hip; Total hip arthroplasty.

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