title: A comparison of surgical approaches for primary hip arthroplasty: a cohort study of patient reported outcome measures (PROMs) and early revision using linked national databases.
abstract: The posterior and lateral approaches to primary hip arthroplasty were compared using national data from England and Wales. Specific component combinations of the most commonly used cemented and cementless implant brands were analysed separately. There was no significant difference between the approaches for all-cause revision risk (cemented: P = 0.726, cementless: P = 0.295) and revision for dislocation (P = 0.176, P = 0.695) at 12 months following 37,593 procedures, after adjusting for patient and surgical variables. Analysis of 3881 linked episodes found the posterior approach was associated with significantly higher improvement in function (Oxford Hip Score: 20.8 versus 18.9, P < 0.001 (cemented procedures); 21.7 versus 20.2, P = 0.008 (cementless), EQ5D index: 0.416 versus 0.383, P = 0.003; 0.431 versus 0.384, P = 0.003). The posterior approach may offer a functional benefit (albeit small clinically), without increased revision risk.
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; The National Joint Registry for England and Wales.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Jameson
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK.
authors.forename: James
authors.initials: J
authors.lastname: Mason
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; The National Joint Registry for England and Wales.
authors.forename: Paul
authors.initials: P
authors.lastname: Baker
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; The National Joint Registry for England and Wales; The James Cook University Hospital, Marton Road, Middlesbrough, UK.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gregg
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; The James Cook University Hospital, Marton Road, Middlesbrough, UK.
authors.forename: Ian A
authors.initials: IA
authors.lastname: McMurtry
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; Newcastle Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Deehan
authors.affiliation: School of Medicine Health, Durham University, Queen's Campus, University Boulevard, Stockton-on-Tees, UK; Northumbria Healthcare NHS Foundation Trust, Northumberland, UK.
authors.forename: Mike R
authors.initials: MR
authors.lastname: Reed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D004739:England; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D063868:Patient Outcome Assessment; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014852:Wales
keywords: joint registry data; lateral approach; outcome scores; posterior approach; primary hip replacement