Anterolateral minimally-invasive total hip arthroplasty: a clinical comparative study of 110 cases

Abstract

To explore the indications and key points of anterolateral minimally-invasive total hip arthroplasty. 110 baseline indexes matched patients admitted for unilateral total hip arthroplasty were randomly assigned to 2 equal groups to undergo surgery through a short anterolateral incision of < or = 10 cm or a standard posterolateral incision. All operations were done by the same surgeon. The demographic data, perioperative indexes, and postoperative function indexes were recorded and statistically analyzed. No significant differences were detected with respect to operation time, abduction angle, anteversion angle, stem alignment, and stem fixation between these 2 groups. The incision length, blood loss, perioperative transfusion, and 100 - mm visual analogue pain scale (VAS) score at the first 24 hours of the anterolateral approach group were (7.49 +/- 0.86) cm, (376.18 +/- 168.30) ml, (410.09 +/- 136.46) ml, and (30.76 +/- 21.77) respectively, all significantly shorter, less, or lower than those of the standard posterolateral approach group [(15.2 +/- 1.8) cm, (605.0 +/- 225.1) ml, (629.5 +/- 232.9) ml, and (50.3 +/- 13.7) respectively, all P < 0.01]. The Harris hip score and Barthel index 3 months after operation of the anterolateral approach group were (83.80 +/- 5.64) and (93.45 +/- 6.37) respectively, both significantly higher than those of the standard posterolateral approach group [(75.0 +/- 7.5) and (94.6 +/- 7.5) respectively, both P < 0.01)], however, there were not significant differences in the Harris hip score and Barthel index 3 years after operation between these 2 groups. Fewer traumas, less blood loss and rapid recovery can be obtained through this new total hip arthroplasty approach. But experienced doctors and special instruments are prerequisite.