The use of powered broaching (PB) is a rising trend for femoral canal preparation in direct anterior (DA) approach total hip arthroplasty (THA) to deliver consistent impaction forces and reduce workload. This study aims to compare the early experiences and outcomes of a new powered impactor with an established powered femoral broaching device. Our institutional database was reviewed for all patients undergoing primary DA THA from August 2022 to November 2024 that used either the established device (Group A) or the new device (Group B). There were 506 THAs (Group A = 400, Group B = 106) performed by one surgeon included. Complications and revisions in the first 90 days, as well as patient-reported outcome measures (PROMs) and aseptic survivorship were compared. Differences in length of follow-up and demographics were assessed. In the first 90 days of follow-up, there was 1 aseptic revision in each group; one due to periprosthetic fracture in Group A and one due to stem subsidence in Group B. Group A had three additional complications while Group B had two. There were no statistically significant differences in aseptic survivorship (P=0.25) and no clinically important differences in PROMs. Our single-center single-surgeon early experience with a novel powered femoral impactor demonstrates it may be a safe and effective alternative to an established powered broaching device in the application of primary DA THA. Low rates of periprosthetic fractures (0.5% versus 0%), 90-day complications (1.0% versus 2.83%), and 90-day revisions (0.25% versus 0.94%) can be achieved.
Olson et al. (Sun,) studied this question.