Association of surgeon volume with complications following direct anterior approach (DAA) total hip arthroplasty: a population-based study
Issued Date
2024-01-01
Resource Type
ISSN
17453674
eISSN
17453682
Scopus ID
2-s2.0-85205326438
Journal Title
Acta Orthopaedica
Volume
95
Start Page
505
End Page
511
Rights Holder(s)
SCOPUS
Bibliographic Citation
Acta Orthopaedica Vol.95 (2024) , 505-511
Suggested Citation
Ruangsomboon P., Bagouri E., Pincus D., Paterson J.M., Ravi B. Association of surgeon volume with complications following direct anterior approach (DAA) total hip arthroplasty: a population-based study. Acta Orthopaedica Vol.95 (2024) , 505-511. 511. doi:10.2340/17453674.2024.41506 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101512
Title
Association of surgeon volume with complications following direct anterior approach (DAA) total hip arthroplasty: a population-based study
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Abstract
Background and purpose — Total hip arthroplasty (THA) can be performed through various surgical approaches, including direct anterior (DAA). DAA-THA may offer faster recovery but carries a higher risk of complications, which may be mitigated by surgeon volume and experience. We examined the association of surgeons’ annual surgical volume with major complications after DAA-THA in a population-based sample. Methods — A population-based retrospective cohort study was carried out on primary DAA-THA patients in Ontario between April 2016 and March 2021. We used restricted cubic splines to visually define the association between annual DAA surgeon volume and the risk of major surgical complications (fractures, dislocations, infections, and revisions) within 1 year of surgery. We further compared the complication rates amongst different DAA volume categories (< 30, 30–60, and > 60 cases/year). Results — The study encompassed 9,672 DAA-THA patients (52% female, median age 67 years). We showed a sharp decline in the probability of complications as the surgical volume of DAA-THA increased within the lower range of 0–30 cases/year; the probability slightly increased after the surgical volume exceeded 60 cases/year. The overall complication rates were 3.09%, 2.24%, and 2.18% for the surgical experience group of < 30 cases/year, 30–60 cases/ year, and > 60 cases/year, respectively. Conclusion — There was an inverse relationship between surgical volume and complication rates in DAA-THA within the lower volume ranges. Maintaining a surgical volume of at least 30 DAA-THA cases/year can minimize complications, emphasizing the importance of surgical volume in this approach.