The Direct Anterior Approach (DAA) for the Salvage Total Hip Arthroplasty after Failed Osteosynthesis of Hip Fractures

Total hip arthroplasty is an effective salvage procedure after failed internal fixation of a prior hip fracture, it is technically more difficult than the routine primary THA. The Direct Anterior Approach (DAA) was used in our study. The purpose of this study was to evaluate the intraoperative complications and the short term functional outcome. Between 2015-2018, we performed 37 salvage total hip arthroplasties, the etiology of the failed osteosynthesis included osteonecrosis, nonunion and arthritis. There were 17 women and 20 men, age ranged from 41 to 82 years old with a mean age of 61 years. Time to Salvage THA procedure ranged from 236 to 9125 days. Time of surgery ranged from 50 minutes to 147 minutes with mean time of 91 minutes. The mean hemoglobin drop at POD 3 was 3.3 g/dl. The length of stay in hospital ranged from 2 to 5 days with a mean length of 3.5 days. In addition, our analyses revealed a not significantly increased risk of intraoperative complications and the short term functional outcome is similar to primary THA in active patients.