H. John Cooper

MD

Associate Professor, Columbia University Irving Medical Center

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Mohit Bhandari

FRCSC, PhD

Distinguished University Professor, Chair of Surgery, McMaster University

This session reviewed a multicenter RCT evaluating closed-incision negative-pressure therapy for high-risk patients undergoing direct anterior THA. Prior work shows elevated wound-healing complications with this approach, especially among patients with obesity, diabetes, smoking, or prior hip surgery. In the trial, complication rates trended lower with negative-pressure therapy (18% vs 8%) and superficial infections were significantly reduced (15% vs 3%), though the study was underpowered for its primary endpoint. Case examples illustrated meaningful clinical differences, with faster healing and fewer management burdens in the negative-pressure cohort. The discussion emphasized cost-effectiveness, appropriate patient selection, and practical integration into wound-care protocols. Overall, the study suggests that adopting targeted negative-pressure therapy can meaningfully reduce wound-related morbidity in high-risk primary THA patients.