THE TRANSTROCHANTERIC AND ANTERO-LATERAL APPROACHES IN PRIMARY HIP ARTHROPLASTY: COMPARISON OF MORBIDITY

Abstract

Introduction. Total hip arthroplasty is one of the most successful operations performed by an orthopaedic surgeon. There are three surgical approaches in use since Charnley popularised the trans-trochanteric approach. Opinion has been divided as to which approach is superior.

Aim. This study was designed to examine the difference in morbidity between the classical Charnley trans-tro-chanteric approach and the antero-lateral trans-gluteal (Hardinge) approach in primary hip arthroplasty.

Methods. Information on 891 patients, who underwent primary total hip arthroplasty performed by a single surgeon, was collected prospectively between 1998–2003 using a modified SF-36 form, pre-operatively, intra-operatively, and at three months. Information collected includes patient demographics, diagnosis, intra-operative blood-loss, and post-operative satisfaction and range of motion. Information was collected on the Excel database and analysed using Minitab statistical package.

Results. The two groups were statistically similar for gender and side of pathology. There was no statistical difference in blood-loss between the groups. There was higher morbidity in the TT group. More patients were doubtful or dissatisfied with the THR in the TT group. There was a greater range of motion in the Hardinge group.

Conclusion. In this study population, the trans-trochanteric approach was associated with higher morbidity, a lower patient satisfaction rating and a lower range of motion.