ArticleJB & JS open access
Surgical Approach to Total Hip Arthroplasty Affects the Organism Profile of Early Periprosthetic Joint Infections.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Surgical Approach and Microbiologic Trends in Hip Periprosthetic Joint Infection: A Retrospective Comparison of Anterior and Posterior THA.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Comparison of clinical efficacy of Ganz approach and K-L approach in treatment of Pipkin type IV femoral head fracture.BMC surgery · 2025Observational
- Approach-specific complication management in direct anterior approach total hip arthroplasty.Orthopadie (Heidelberg, Germany) · 2025Review
- Direct anterior approach enhances early recovery outcomes in total hip arthroplasty among elderly individuals with femoral neck fractures: a propensity-matched cohort study.Journal of orthopaedic surgery and research · 2025Observational
- Incidence of PJI in Total Knee Arthroplasty Patients Following Expanded Gram-Negative Antibiotic Prophylactic Protocol.Microorganisms · 2025Article
- Surgical approaches in total hip arthroplasty do not influence the bacterial spectrum of acute postoperative periprosthetic joint infections.Journal of bone and joint infection · 2025Article
- Qualitative Comparison of Cultured Skin Microbiota From the Inguinal Region of Obese and Nonobese Patients Eligible for Hip Arthroplasty.Arthroplasty today · 2024Article
- Article
- Clinical outcomes of DAA and related techniques in hip arthroplasty.Arthroplasty (London, England) · 2023Review
- Increased Rate of Early Periprosthetic Joint Infection in Total Hip Arthroplasty With the Use of Alternatives to Cefazolin Despite Additional Gram-Negative Coverage.Arthroplasty today · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The optimal approach for total hip arthroplasty (THA) remains hotly debated. While wound complications following the direct anterior approach are higher than with other approaches, the organism profile of periprosthetic joint infections (PJIs) by approach remains unknown. Our goal was to compare the organism profiles of PJIs following direct anterior and non-anterior THA.
methodsWe retrospectively reviewed 12,549 primary THAs (4,515 direct anterior and 8,034 non-anterior) that had been performed between January 2012 and September 2019 at a university-affiliated single-specialty orthopaedic hospital to identify patients with an early postoperative PJI. Criteria used for the diagnosis of a PJI were the National Healthcare Safety Network, which screens for PJI that occurs within 90 days of index arthroplasty, and the Musculoskeletal Infection Society guidelines. Patient demographic information and organism characteristics were recorded for analysis.
resultsWe identified 84 patients (38 who underwent the direct anterior approach and 46 who underwent the non-anterior approach) with an early postoperative PJI following primary THA (0.67% total THA PJI rate, 0.84% direct anterior THA PJI rate, and 0.57% non-anterior THA PJI rate). The direct anterior THA cohort had a significantly lower body mass index and American Society of Anesthesiologists score than the non-anterior THA cohort (29.5 versus 35.2 kg/m
conclusionsDirect anterior THA approaches have a greater risk of monomicrobial gram-negative PJI, likely due to the unique microbiome of the inguinal region. While targeted infection prophylaxis may reduce these infections, it is not entirely effective on its own. Future studies with larger sample sizes are required to help us develop more targeted perioperative infection prophylaxis. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.