A retrospective analysis of surgical outcomes following direct anterior hip arthroplasty with or without a surgical extension table

Abstract

Purpose Using a surgical extension table during total hip arthroplasty (THA) is widely considered state-of-the-art. However, intra-operative leg positioning requires additional time and leg length determination can be challenging. Our study's aim was to compare patient outcomes, particularly leg length precision, following surgery with or without an extension table. Methods This retrospective study included data from medical records of 324 patients who underwent THA using the direct anterior approach by one surgeon at a Swiss cantonal hospital (2015-2017). Patients were grouped by table type-standard (T-S) or extension table (T-E). Variables analyzed were demographics, operative/anaesthetic conditions, and medical outcomes. The leg length was measured pre- and post-operatively with mediCAD Classic (R). Results An extension table was used in 161 (49.7%) patients. The median operative duration (minutes) was shorter in T-S (55 (interquartile range (IQR) 48-67) than T-E (60 (IQR 54-69)) (p = 0.002) and blood loss (ml) was lower (T-S = 400 (IQR 300-500), T-E = 500 (IQR 300-600), p = 0.0175). The median post-operative leg length discrepancy (mm) was less in T-S (T-S = 1 (IQR 0-3), T-E = 2 (IQR 0-4), p = 0.0122). All four dislocations occurred in T-E, and 7.4% of patients had complications (T-S = 7%, T-E = 7.5%, p = 0.99). Conclusion We found that operating on a standard table during THA resulted in slightly more favourable outcomes. Given the added expenses, human resources, and time associated with an extension table, opting for a standard table remains a sensible choice.