A Comparative Evaluation of Primary Total Hip Arthroplasty via Lateral and Posterolateral Approaches

Abstract

Background: Total hip arthroplasty (THA) is regarded as the most successful and common surgical approach in orthopedic surgeries. Several surgical approaches have been described for THA to introduce minimally invasive surgical exposures. Posterolateral and lateral approaches are traditional and still most commonly used approaches for primary THA. In deciding which approach to use, consideration of complications, and clinical and radiological outcomes, using one approach or another should be evaluated. Objectives: The purpose of this study was to compare the early postoperative outcomes of posterolateral and lateral surgical approaches. Patients and Methods: The current study was conducted on a group of 134 primary hip arthroplasty of 120 patients who had undergone THA surgery at Shafa Orthopedic Hospital in Tehran, Iran, from March 2011 to October 2014. The lateral approach was used in 79 hips and, posterolateral approach was used in 55 hip based on surgeon’s preference. Two groups were assessed considering the following outcomes: clinical evaluation including Harris hip score (HHS), blood loss, blood transfusion, hemoglobin level, infections, deep vein thrombosis (DVT) and dislocation, as well as radiological evaluation including the proximal femur fracture, limb length discrepancy and cup inclination angle. The follow-up for both groups was at 6, 12, 24, 36 and 48 weeks after the surgery. Results: There was no significant difference between the two approaches regarding demographic characteristics, HHS, blood loss, transfusion, hemoglobin level, dislocation and cup inclination angle. However, there was a significant difference in the incidences of infections, DVT, proximal femur fracture and discrepancy of limb length between the two approaches. Conclusions: The results of this study indicate that both lateral and posterolateral approaches offer similar early clinical outcomes and some different radiological outcomes.