Cohort study finds elevated body mass index and longer surgery increase wound complications in hip arthroplasty, highlighting targets for risk reduction.
Key Points
Identify independent risk factors for wound complications following direct anterior approach total hip arthroplasty and evaluate the prophylactic effectiveness of negative pressure wound therapy.
Retrospectively reviewed N=725 patients who underwent direct anterior approach total hip arthroplasty performed by five surgeons at a single institution between 2011 and 2023.
Analyzed patient demographics, surgical variables, and clinical outcomes using univariate and multivariate logistic regression models.
Overall, 83 (11.4%) patients developed wound complications, with independent risk factors being higher BMI (OR 1.06, 95% CI [1.01–1.11], p = 0.016), longer operative time (OR 1.01, 95% CI [1.00–1.01], p = 0.004), and prophylactic NPWT use (OR 2.1, 95% CI [1.2–3.9], p = 0.016).
Patients with wound complications experienced significantly higher rates of 90-day emergency visits (10.8% vs. 4.4%, p = 0.018), hospital readmissions (15.7% vs. 3.9%, p < 0.001), all-cause revisions (19.3% vs. 2.8%, p < 0.001), and periprosthetic joint infections (13.3% vs. 0.5%, p = 0.005).