Direct Lateral Group Research Articles

Intraoperative Muscle Damage in Total Hip Arthroplasty

Tenderness in the medial and posterior thigh is sometimes observed during the early postoperative period after total hip arthroplasty (THA). In this study, the possible correlations of preoperative hip range of motion, surgical approach, and limb lengthening with postoperative muscle strain injury in THA were investigated. Sixty primary THA patients given the posterolateral approach or direct-lateral approach were examined. For comparison of the muscle strain injury in the 2 groups, we used magnetic resonance imaging. There were significant differences in postoperative thigh pain between cases in the posterolateral group with reduction of internal rotation and those with no reduction, and between cases in the direct-lateral group with reduction of external rotation and those with no reduction.

Abductor function after total hip replacement. An electromyographic and clinical review.

Electromyographic and clinical studies were performed on patients undergoing total hip replacement by the modified direct lateral (29 hips), the direct lateral (29 hips) and the posterior approaches (21 hips). Assessments were made three months after operation. The Trendelenburg test was positive (Grade II) in eight cases operated upon by the direct lateral route, but in only one of each of the other two groups. Denervation occurred in only five of the 28 hips with abductor weakness without statistical difference between the groups. In the modified direct lateral group, radiological evidence of union of the trochanteric sliver was associated with significantly better abductor function than in those with malunion or non-union.