Comparision of the early functional outcome between lateral and posterior approaches in total hip arthroplasty

Abstract

Background: The choice of surgical approach for THA remains a contentious issue with regards to restoration of patient function and optimization of clinical outcome. In this study we planned to compare early functional outcome between posterior and lateral approaches using Harris Hip score and Trendelenburg test.Methods: Patients undergoing THA were assigned to the two groups to be operated by either Lateral or the posterior approach for the procedure of Total Hip Arthroplasty. Function of the hips was assessed at 2 week, 3 & 6 months after surgery using Harris hip score and Trendelenburg Test.Results: We included 30 patients in our analysis (15 Lateral and 15 posterior). The groups were similar with respect to age (p=.79), Gender (p=.705). Temporal parameters were similar among the groups at all time points. At 2 weeks, there is negative trendelenburg test in all the patients operated by posterior approach as well as lateral approach. At 3 and 6 Months, there is negative trendelenburg test in all the patients operated by posterior approach, while 13.33% patients operated with lateral approach had positive trendelenberg test. No significant difference was seen in pain at 2 weeks, at 3 months, at 6 months between posterior approach and lateral approach (p value >.05). Conclusion: From this study the functional outcome and Trendelenburg test have statistically no significant difference in both lateral and posterior approach. Good surgical technique and awareness of the anatomy of the nerve supply are key factors in preserving good abductor strength.