A DIRECT ANTERIOR APPROACH RESULTS IN NO SIGNIFICANT CLINICAL IMPROVEMENT WHEN COMPARED TO A MINI-POSTERIOR APPROACH FOR MINIMALLY-INVASIVE TOTAL HIP ARTHROPLASTY

Abstract

Introduction: Minimally Invasive Hip surgery has been described using several different surgical techniques. These can be divided into two broad groups, those that utilise smaller incision version of a conventional approach (mini-posterior) and those that use a muscle-sparing technique (direct anterior). The muscle-sparing technique has been promoted as the only true Minimally-invasive Total Hip Replacement (MISTHR) as it intuitively appears more minimally invasive with less soft tissue disruption. We have therefore carried out a prospective analysis of 60 consecutive direct anterior MISTHRs case-matched to 60 mini-posterior MISTHRs.

Materials and Methods: We prospectively analysed 60 consecutive, direct anterior approach patients with case-matched mini-posterior approach patients. Functional outcome was assessed with the Visual Analogue Pain Score (VAS), Merle d’Aubigne Postel (MDP), the Oxford Hip (OHQ) and SF-36 questionnaires at 6 weeks and 6 months post-operatively. Peri-operative blood loss, length of surgery and length of stay were recorded.

Results: (table removed)

Conclusions: Our conclusions are that both approaches are safe, with low complication rates and offer excellent clinical outcomes. However, there is no significant difference between the two approaches justifying the more technically difficult, but muscle-sparing anterior approach.