Incidence of deep vein thrombosis following total hip arthroplasty using the anterolateral supine, direct lateral, and posterolateral approaches: a retrospective study

This study investigated the impact of surgical approach on the incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA). This retrospective single-center study investigated 1675 consecutive patients who underwent primary unilateral THA. Patients were divided according to the surgical approach into anterolateral supine (ALS; n = 408), direct lateral (DL; n = 629), and posterolateral (PL; n = 638) groups. Each surgical approach was performed by a single, highly experienced, high-volume surgeon according to their personal preference. Doppler ultrasound was performed in all patients 1 month before and 7 days after surgery to detect DVT in the lower extremities. The PL group had the lowest Japanese Orthopaedic Association scores and the longest operation times (both p < 0.001). Post-operative C-reactive protein was lowest in the ALS group ( p < 0.001). The frequency of post-operative DVT was 4.6% in the ALS group, 7.9% in the DL group, and 10.7% in the PL group ( p = 0.003). Multiple logistic regression analysis identified the following risk factors for DVT following THA: age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03–1.08), body mass index (OR 1.06, 95% CI 1.03–1.12), D-dimer (OR 1.06, 95% CI 1.02–1.10), and PL approach ( vs . ALS approach, OR 4.62, 95% CI 2.20–9.70; vs . DL approach, OR 2.82, 95% CI 1.40–5.68). Although various factors influence the occurrence of DVT, the ALS approach may potentially reduce the post-operative inflammatory response and contribute to a decrease in the occurrence of post-operative DVT. • The impact of surgical approach on deep vein thrombosis (DVT) in THA remains unknown. • This study investigated the impact of surgical approach on the incidence of DVT. • Post-operative CRP and the incidence of DVT were lower in the anterolateral supine group. • Age, BMI, D-dimer, and PL approach were identified as risk factors for DVT. • The ALS approach may contribute to a decrease in the occurrence of DVT.