ArticleActa orthopaedica2023
Revision risk by using the direct superior approach (DSA) for total hip arthroplasty compared with postero-lateral approach: early nationwide results from the Dutch Arthroplasty Register (LROI).
Article in Acta orthopaedica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Direct Superior Approach in Total Hip Arthroplasty: A Systematic Review.JBJS reviews · 2024Pooled it
- Direct superior approach versus posterolateral approach in mid-term clinical outcomes of total hip arthroplasty: a prospective randomized controlled study.BMC musculoskeletal disorders · 2025Trial
- Clinical efficacy of supine direct-superior approach versus posterolateral approach in hemiarthroplasty for femoral neck fractures in elderly patients.BMC musculoskeletal disorders · 2026Article
- Deep learning-assisted 3D CT angiography for supply-vessel localization in inflammatory peripheral pulmonary artery pseudoaneurysms.Frontiers in medicine · 2026Article
- Evaluating the direct superior approach compared to the traditional posterior approach for hip arthroplasty: A systematic review and meta-analysis.Journal of orthopaedics · 2025Review
- Piriformis preservation in total hip arthroplasty: do we have a new concept? An update on anatomy, function and clinical outcomes.EFORT open reviews · 2025Article
- Early Postoperative Outcomes of the Direct Superior Approach versus the Posterior Approach in Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Time trends in case-mix and risk of revision following hip and knee arthroplasty in public and private hospitals: a cross-sectional analysis based on 476,312 procedures from the Dutch Arthroplasty Register.Acta orthopaedica · 2024Article
- Femoral Neck Design Does Not Impact Revision Risk After Primary Total Hip Arthroplasty Using a Dual Mobility Cup.Arthroplasty today · 2024Article
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7 authors.
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Abstract
background and purposeThe direct superior approach (DSA) is a modification of the classic posterolateral approach (PLA) for total hip arthroplasty (THA), in which the iliotibial band and short external rotators are spared. The revision rate of the DSA has not been investigated previously using arthroplasty registry data. We examined the reasons and risk of revision of the DSA, compared with the direct anterior approach (DAA) and PLA. PATIENTS AND
methodsIn this population-based cohort study we included 175,543 primary THAs performed between 2014 and 2020 (PLA, n = 117,576; DAA, n = 56,626; DSA, n = 1,341). Competing risk survival analysis and multivariable Cox proportional hazard analyses, adjusted for potential confounders, were performed.
resultsAfter 3 years, crude revision rates due to any reason were 2.1% (95% confidence interval [CI] 1.3-3.3) for DSA, and 2.9% (CI 2.8-3.0) for PLA. Crude dislocation revision rates were 0.3% (CI 0.1-0.8) for DSA, versus 1.0% (CI 0.9-1.0) for PLA. Dislocation revision rate for DSA did not differ from DAA (0.3% [CI 0.2-0.3]). Multivariable Cox regression analysis demonstrated no overall difference in revision rates for the DSA (HR 0.6 [CI 0.4-1.09) compared with the PLA. Lower risk of revision due to dislocation was found in patients operated on through the DSA (HR 0.3 [0.1-0.9]) compared with the PLA.
conclusionEarly nationwide results suggest that the DSA for total hip arthroplasty seems to show a tendency towards a lower risk of revision for dislocation but no overall reduced revision risk compared with the PLA.
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