title: Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review.
abstract: To investigate the prevalence of heterotopic ossification following direct anterior approach total hip arthroplasty compared to posterior approach, performed by a single surgeon at one institution
  
  
  
  All primary THAs performed by the senior author (JEL) over a 70-month period were reviewed, including 235 DAA and 120 posterior THAs. Brooker's system was used to grade HO at a minimum of six months follow-up.
  
  
  
  Patients undergoing DAA were less likely to develop clinically significant HO compared to posterior THA (p = 0.04). The overall incidence of HO following DAA THA was 24.3 % (3 % grade 3 and 0 % grade 4), and following posterior THA was 27.5 % (4.2 % grade 3 and 3.3 % grade 4).
  
  
  
  Lower rates of clinically significant (Brooker grade 3 and 4) HO were observed in DAA THA than in posterior approach THA. This data may be instructive when approaching THA candidates with conditions that predispose them to HO.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Newman
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Holst
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Bracey
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Russell
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. jlang@wakehealth.edu.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Lang
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D006801:Humans; D015994:Incidence; D009999:Ossification, Heterotopic; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Brooker classification; Direct anterior approach total hip; Heterotopic ossification; Posterior approach total hip; Total hip arthroplasty