Posterior versus direct anterior approach in revision hip arthroplasty using Kerboull-type plate

Abstract

Introduction: The purpose of this study was to investigate revision with a Kerboull-type plate through the posterior approach (PA) and direct anterior approach (DAA) and compare the clinical outcome. Subjects and methods: Fifty-four patients (56 hip joints) underwent revision surgery in which acetabular reconstruction was performed concomitantly using the Kerboull-type plate and allogeneic bone. Revision surgery through DAA was performed in 21 hip joints and these were compared with 34 hip joints treated through PA. There was no significant difference in the patient demographics between the DAA and PA. Results: There was no significant difference between the operative times in the DAA and PA groups (203.2 ± 43.5 and 211.7 ± 41.8 min). There was a significant difference between the intraoperative blood loss in the DAA and PA groups (503.9 ± 223.7 mL and 703.8 ± 329.6 mL, respectively, p < 0.05). There was no significant difference between the modified Harris Hip Score in the DAA and the PA groups. The loosening of the acetabular component was observed in four cases (11.8%) in the PA group. In the DAA and PA groups, the 5-year survival rates were 100 and 85.7%, respectively. Recurrent dislocation of the hip was observed in six cases (one case in the DAA group (4.8%) and five cases in the PA group (14.7%)). Conclusions: It was verified that the difference in the surgical approach of acetabular reconstruction concomitantly using the Kerboull-type plate and allogeneic bone graft influenced the postoperative outcome.

Keywords

• direct anterior approach
• posterior approach
• revision hip arthroplasty
• kerboull-type reinforcement device