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. 2020 Apr 28;33(3):336-341.
doi: 10.1080/08998280.2020.1753455. eCollection 2020 Jul.

Predictive value of lateral soft tissue thickness for complications after total hip arthroplasty with a lateral incision

Gregory R Sprowls  1   2 , Bryce C Allen  1   2 , Travis J Wilson  1   2 , Jessica E Pruszynski  3 , Kendall A P Hammonds  3
Affiliations

Predictive value of lateral soft tissue thickness for complications after total hip arthroplasty with a lateral incision

Gregory R Sprowls et al. Proc (Bayl Univ Med Cent). .

Abstract

The purpose of this study was to determine the relationship between soft tissue thickness lateral to the greater trochanter, as measured on anteroposterior pelvis radiograph, and postoperative complications following primary total hip arthroplasty. A retrospective review of 1110 consecutive patients treated at a single institution from 2003 to 2011 was conducted. Postoperative complications were divided into surgical site infections, deep wound infections, noninfectious surgical complications, need for revision surgery, and medical complications. Lateral soft tissue thickness (LSTT) was measured as the horizontal distance from the most lateral point on the greater trochanter to the skin edge obtained from anteroposterior hip radiographs. Among the 1110 study patients, 19.19% had a postoperative complication, with a deep infection rate of 3.42%. Of the previously identified risk factors, increased LSTT and body mass index were both associated with surgical site infection and deep infection, and LSTT was associated with revision surgery. An LSTT value of >5 cm was predictive of surgical site infection, deep infection, and revision surgery. This easily obtainable radiographic measurement, along with clinical examination near the operative site, might prove helpful in making preoperative risk assessments.

Keywords: Lateral soft tissue thickness; surgical site infections; total hip arthroplasty.

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Figures

Figure 1.
Figure 1.
The measurement of lateral soft tissue thickness from a supine, postoperative anteroposterior radiograph of the hip.
Figure 2.
Figure 2.
Probability of (a) surgical site infection, (b) deep infection, and (c) revision surgery associated with lateral soft tissue thickness.
See this image and copyright information in PMC

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