Lower risk of postoperative complications with Hardinge approach in revision total hip replacement surgery.
- 1Singapore General Hospital, 10 Hospital Boulevard, Singapore 168582, Singapore.
- 2Hopsital Tuanku Ja'afar, Jalan Rasah, Bukit Rasah, 70300 Seremban, Negeri Sembilan, Malaysia.
Abstract
Introduction
The increasing volume of total hip replacement (THR), coupled with longer life expectancy and greater patient demands, is expected to result in a corresponding increase in revision THR. The surgical approach used for revision THR may influence postoperative outcomes, particularly the risk of dislocation. This study aimed to compare clinical outcomes following revision THR performed through the lateral and posterior approaches, with particular emphasis on postoperative dislocation rates.Methods
We retrospectively reviewed prospectively collected registry data from 137 patients who underwent revision THR. Of these, 81 underwent revision THR through a lateral approach and 56 through a posterior approach. Propensity scores were generated using logistic regression to adjust for potential confounders, including age, sex, body mass index, and preoperative patient-reported outcome measures (Oxford Hip Score, WOMAC Pain, Stiffness and Physical Function scores, and SF-36 Physical and Mental Component Scores). Postoperative outcomes, including dislocation, blood loss, patient-reported outcome measures, and satisfaction, were compared between groups.Results
After propensity score matching, the incidence of dislocation was significantly higher in the posterior approach group than in the lateral approach group (16.1% vs. 1.8%, p = 0.02). The lateral approach was also associated with significantly lower postoperative blood loss compared with the posterior approach (change in haemoglobin: 1.5 vs. 2.5 g/dL, p < 0.001). No significant differences were observed between groups in SF-36, WOMAC, or Oxford Hip Scores at 6 months or 2 years postoperatively. However, patient satisfaction was significantly higher following the lateral approach at both 6 months (87.5% vs. 73.2% satisfied or very satisfied, p = 0.02) and 2 years (87.5% vs. 67.9%, p = 0.019).Discussion
In this cohort, revision THR performed through a lateral approach was associated with a significantly lower dislocation rate, lower blood loss, and higher patient satisfaction compared with the posterior approach, without significant differences in functional or health-related quality-of-life outcomes. The lateral approach appears to be a viable option for revision THR, particularly when minimising postoperative instability is a priority. Further comparative studies are warranted to validate these findings and determine the influence of surgical approach on outcomes following revision THR.
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BibTeX
@article{wong2026lower,
title = {{Lower risk of postoperative complications with Hardinge approach in revision total hip replacement surgery.}},
author = {Seng Juong Wong and Sasidaran Ramalingam and Andy Yew Khye Soon and Joel Yat Seng Wong and Audrey Xinyun Han and Eric Xuan Liu and Lincoln Ming Han Liow and Darren Keng Jin Tay and Seng Jin Yeo and Hee Nee Pang},
journal = {SICOT-J},
year = {2026},
month = oct,
doi = {10.1051/sicotj/2026011},
url = {https://europepmc.org/article/MED/42905991},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lower risk of postoperative complications with Hardinge approach in revision total hip replacement surgery.
AU - Seng Juong Wong
AU - Sasidaran Ramalingam
AU - Andy Yew Khye Soon
AU - Joel Yat Seng Wong
AU - Audrey Xinyun Han
AU - Eric Xuan Liu
AU - Lincoln Ming Han Liow
AU - Darren Keng Jin Tay
AU - Seng Jin Yeo
AU - Hee Nee Pang
PY - 2026
DA - 2026/10/21
JO - SICOT-J
DO - 10.1051/sicotj/2026011
UR - https://europepmc.org/article/MED/42905991
AB - Introduction The increasing volume of total hip replacement (THR), coupled with longer life expectancy and greater patient demands, is expected to result in a corresponding increase in revision THR. The surgical approach used for revision THR may influence postoperative outcomes, particularly the risk of dislocation. This study aimed to compare clinical outcomes following revision THR performed through the lateral and posterior approaches, with particular emphasis on postoperative dislocation rates.Methods We retrospectively reviewed prospectively collected registry data from 137 patients who underwent revision THR. Of these, 81 underwent revision THR through a lateral approach and 56 through a posterior approach. Propensity scores were generated using logistic regression to adjust for potential confounders, including age, sex, body mass index, and preoperative patient-reported outcome measures (Oxford Hip Score, WOMAC Pain, Stiffness and Physical Function scores, and SF-36 Physical and Mental Component Scores). Postoperative outcomes, including dislocation, blood loss, patient-reported outcome measures, and satisfaction, were compared between groups.Results After propensity score matching, the incidence of dislocation was significantly higher in the posterior approach group than in the lateral approach group (16.1% vs. 1.8%, p = 0.02). The lateral approach was also associated with significantly lower postoperative blood loss compared with the posterior approach (change in haemoglobin: 1.5 vs. 2.5 g/dL, p < 0.001). No significant differences were observed between groups in SF-36, WOMAC, or Oxford Hip Scores at 6 months or 2 years postoperatively. However, patient satisfaction was significantly higher following the lateral approach at both 6 months (87.5% vs. 73.2% satisfied or very satisfied, p = 0.02) and 2 years (87.5% vs. 67.9%, p = 0.019).Discussion In this cohort, revision THR performed through a lateral approach was associated with a significantly lower dislocation rate, lower blood loss, and higher patient satisfaction compared with the posterior approach, without significant differences in functional or health-related quality-of-life outcomes. The lateral approach appears to be a viable option for revision THR, particularly when minimising postoperative instability is a priority. Further comparative studies are warranted to validate these findings and determine the influence of surgical approach on outcomes following revision THR.
SN - 2426-8887
ER -