Modified Watson-Jones approach versus modified Hardinge approach for total hip arthroplasty

Abstract

Objective To compare clinical results of modified Watson-Jones minimally invasive approach and modified Hardinge approach in total hip arthroplasty(THA).Methods This study reviewed 90 patients who had undergone THA from January 2005 through February 2008.The modified Watson-Jones approach was used in 44 patients(group A),20 men and 24 women,with an average age of 68.2 ±8.0 years; the modified Hardinge approach was used in 46 patients(group B),21 men and 25 women,with an average age of 69.1 ± 9.2 years.The causes of THA were mostly femoral neck fracture(23 cases in group A and 21 cases in group B)and femoral head necrosis(9 cases in group A and 6 cases in group B).All the operations were performed by the same group of surgeons.Clinical evaluation involved the Harris hip scores and Barthel indexes at 3 months and the final follow-up.Radiographs were evaluated to examine the acetabular abduction angle.Complications in both groups were recorded.Results The patients had an average follow-up of 50.9 ± 10.1 months.Group A were significantly superior to group B in incision length,blood loss and ambulant patients within 3 days postoperation(P ＜ 0.05).There was no significant difference between the 2 groups in the acetabular abduction angle.At 3 months postoperation,the mean Harris hip score(82.4 ±3.3)and Barthel index(85.4±3.8)were significantly higher in group A than in group B(72.3 ±3.7 &77.2 ± 5.4)(P ＜ 0.05),but such significant differences between the 2 groups were not observed at the final follow-up(P ＞ 0.05).Complications,such as wound infection,hip dislocation,vascular and neural lesions,and deep vein thrombosis,did not occur in either group.Conclusion Both modified Watson-Jones minimally invasive approach and modified Hardinge approach can be successfully used for total hip replacement,but the former can lead to better functional recovery at 3 months after operation. Key words: Arthroplasty, replacement, hip; Femoral neck fractures; Femur head necrosis; Surgical procedures, minimally invasive