Is the Anterolateral or Posterolateral Approach More Effective for Early Postoperative Recovery after Minimally Invasive Total Hip Arthroplasty?

Abstract

Currently, various minimally invasive surgical techniques are applied for total hip arthroplasty (THA). There are few studies comparing the early postoperative clinical outcomes of minimally invasive THA between anterolateral and posterolateral approaches. In this retrospective study, 62 patients underwent minimally invasive THA via either the anterolateral approach with an intermuscular exposure using the modified Watson-Jones approach (MIS-AL, 34 hips) or mini-incision THA with a posterolateral approach (MIS-PL, 28 hips). We analyzed intraoperative data, postoperative hematological data, postoperative radiographic findings, and the postoperative recovery of muscle strength. The mean surgical time was significantly longer in the MIS-PL than in the MIS-AL group. The mean postoperative serum C-reactive protein level was significantly higher in the MIS-PL group than in the MIS-AL group only on postoperative day 3. There were no significant between-group differences in the postoperative recovery rate of muscle strength during hip abduction. The recovery rate of muscle strength during hip extension was better in the MIS-AL group than in the MIS-PL group only on postoperative day 3. In conclusion, we found no obvious advantage in early postoperative recovery between the MIS-AL and MIS-PL approaches. Therefore, the benefit of rapid postoperative recovery was comparable between the MIS-AL and MIS-PL approaches.