ArticleActa orthopaedica2024
Association of surgeon volume with complications following direct anterior approach (DAA) total hip arthroplasty: a population-based study.
Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effect of surgeon volume on outcomes after total hip arthroplasty: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Comparative analysis of surgical approaches in total hip arthroplasty: a systematic review of comparative outcomes including primary and revision cases.Journal of orthopaedic surgery and research · 2026Pooled it
- Association between intraoperative fluoroscopy for anterior approach total hip arthroplasty and short-term revision risk: an analysis based on 49,878 cases from the Dutch Arthroplasty Register.Acta orthopaedica · 2026Article
- A novel iliofemoral classification for assessing surgical difficulty in direct anterior approach total hip arthroplasty: a retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- Total Hip Arthroplasty Using a Direct Anterior Approach Reduces Postoperative Leg Length Differences by Preserving the Medial Iliofemoral Ligament.Arthroplasty today · 2025Article
- Impact of low body mass index on reoperation risk and complications after joint arthroplasty: a cohort study.International orthopaedics · 2025Article
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5 authors.
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Abstract
background and purposeTotal hip arthroplasty (THA) can be performed through various surgical approaches, including direct anterior (DAA). DAA-THA may offer faster recovery but carries a higher risk of complications, which may be mitigated by surgeon volume and experience. We examined the association of surgeons' annual surgical volume with major complications after DAA-THA in a population-based sample.
methodsA population-based retrospective cohort study was carried out on primary DAA-THA patients in Ontario between April 2016 and March 2021. We used restricted cubic splines to visually define the association between annual DAA surgeon volume and the risk of major surgical complications (fractures, dislocations, infections, and revisions) within 1 year of surgery. We further compared the complication rates amongst different DAA volume categories (< 30, 30-60, and > 60 cases/year).
resultsThe study encompassed 9,672 DAA-THA patients (52% female, median age 67 years). We showed a sharp decline in the probability of complications as the surgical volume of DAA-THA increased within the lower range of 0-30 cases/year; the probability slightly increased after the surgical volume exceeded 60 cases/year. The overall complication rates were 3.09%, 2.24%, and 2.18% for the surgical experience group of < 30 cases/year, 30-60 cases/year, and > 60 cases/year, respectively.
conclusionThere was an inverse relationship between surgical volume and complication rates in DAA-THA within the lower volume ranges. Maintaining a surgical volume of at least 30 DAA-THA cases/year can minimize complications, emphasizing the importance of surgical volume in this approach.
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