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. 2022;42(2):60-65.

Differences in Infection Rates by Surgical Approach in Total Hip Arthroplasty and Patient Sex: A Systematic Review

Dylan T Wolff  1 , Neil V Shah  1 , Ahmed M Eldib  1 , Aadit T Shah  2 , Avi J Panchal  1 , Benjamin Krasnyanskiy  1 , Vivek Singh  3 , Akhilesh Sastry  4 , Qais Naziri  1
Affiliations

Differences in Infection Rates by Surgical Approach in Total Hip Arthroplasty and Patient Sex: A Systematic Review

Dylan T Wolff et al. Iowa Orthop J. 2022.

Abstract

Background: There exists conflicting data that patient sex may influence complication and revision rates when undergoing total hip arthroplasty (THA), specifically when comparing different surgical approaches. Differences in body fat or muscular distribution are proposed mechanisms, but these are poorly understood and not well described in current literature.

Methods: A systematic review of the literature was conducted from PubMed, Embase, and Web of Science from inception of the database through September 15, 2020. Studies were included if they included patients undergoing primary elective unilateral THA, delineated infections by surgical approach, and delineated infections by patient sex. Basic science, cadaveric, and animal studies were excluded as were case reports. Two authors screened abstracts and then extracted data from the full text article.

Results: Three studies, including 1,694 patients undergoing 1,811 THA were included. 80 infections were included. No study reported a statistically significant difference in infection risk by patient sex or surgical approach, though there was substantial heterogeneity in study design, approach, and analysis.

Conclusion: Limited data suggests no relationship between sexes across surgical approaches for infection rates. However, poor reporting and small sample sizes preclude definitive conclusions from being drawn. Future studies should emphasize reporting differences in outcomes by patient sex to better elucidate differences, if any, in adverse outcomes between sexes following THA across surgical approaches. Level of Evidence: IV.

Keywords: anterolateral approach; direct anterior approach; infection; posterior approach; revision; total hip arthroplasty.

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Figures

Figure 1.
Figure 1.
A PRISMA diagram outlining the studies eligible for and included in the present review.
See this image and copyright information in PMC

References

    1. Steiner C, Andrews R, Barrett M WA. HCUP Projections Report # 2012-03. 2012.
    1. Maradit Kremers H, Larson DR, Crowson CS, et al. Prevalence of Total Hip and Knee Replacement in the United States. The Journal of bone and joint surgery American volume. 2015;97(17):1386–1397. doi: 10.2106/JBJS.N.01141. doi: - DOI - PMC - PubMed
    1. Katz JN, Wright EA, Wright J, et al. Twelve-year risk of revision after primary total hip replacement in the U.S. Medicare population. The Journal of bone and joint surgery American volume. 2012;94(20):18251832. doi: 10.2106/JBJS.K.00569. doi: - DOI - PMC - PubMed
    1. Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. The Journal of bone and joint surgery American volume. 2004;86-A(5):963–974. - PubMed
    1. Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report longterm pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ open. 2012;2(1):e000435. doi: 10.1136/bmjopen-2011-000435. doi: - DOI - PMC - PubMed

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