Risk Factors for Wound Complications After Direct Anterior Approach Hip Arthroplasty.
Previous studies have suggested that wound complications may be higher after direct anterior approach (DAA) hip arthroplasty, but, specific risk factors have not been closely examined.



We conducted a retrospective case-control study of 651 consecutive DAA hip arthroplasty surgeries performed by 2 surgeons over a 3-year period. Outcome measures included any postoperative wound problem (including prolonged drainage, wound dehiscence, wound necrosis, suture granuloma, and superficial infection) requiring additional intervention or reoperation. Univariate odds ratios (ORs) were calculated, and multivariate logistic regression analysis was performed to determine risk correlation. Receiver operator characteristic (ROC) curves were created to determine disease predictability.



A total of 75 patients (11.5%) experienced wound complications requiring additional intervention, of which, 13 (1.9%) required reoperation. Multivariate regression analysis found that development of wound complications was significantly and independently associated with body mass index (BMI) 30-35 kg/m2(OR 2.05; 95% confidence interval [CI] 1.08-3.88), BMI 35-40 kg/m2(OR 3.40; 95% CI 1.42-8.26), BMI > 40 kg/m2(OR 7.28; 95% CI 2.55-20.78), and diabetes mellitus (OR 2.97; 95% CI 1.46-6.07). Reoperation for wound complication was significantly associated with BMI > 40 kg/m2(OR 5.68; 95% CI 1.17-27.48) and diabetes mellitus (OR 13.08; 95% CI 3.97-43.11). Optimal cutoff values for BMI were found through receiver operator characteristic curve analysis to be 28.0 kg/m2for development of wound complications and 28.2 kg/m2for reoperation for wound complications.



Obesity and diabetes mellitus are significantly associated with postoperative wound-healing complications and the need for reoperation for these wound complications after DAA hip arthroplasty.
Center for Joint Preservation and Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York.
Kenneth H
KH
Jahng
Center for Joint Preservation and Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York.
Marcel A
MA
Bas
Center for Joint Preservation and Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York.
Jose A
JA
Rodriguez
Center for Joint Preservation and Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York.
H John
HJ
Cooper
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology* / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology
anterior; arthroplasty; complication; diabetes; obesity; wound