Effect of surgical approach on Functional outcome and component Positioning in total hip arthroplasty : a One year hospital based prospective study

Abstract

Introduction : The success of total hip arthroplasty (THA) in addressing pain, mobility, and physical function for osteoarthritis’ patients has led to the procedure being dubbed the "operation of the century”. THA has good 10-year survival rates and 25-year implant survival rates of over 95% and over 80%, respectively. At short and mid-term follow-up, health-related quality of life outcomes following THA have generally ranged from good to excellent. Two of the most often employed surgical techniques for THA are the posterior and direct lateral approaches. In spite of numerous studies assessing the impact of surgical approaches in THA, Jolles and Bogoch's Cochrane review found that they were insufficient to enable a conclusive determination of whether one approach was superior to the other. Of the four prospective cohort studies included in the Cochrane review, only one trial by Barber et al., with a brief follow up of 2 years and a small patient population of only 49, provided functional outcomes using Harris Hip Score (HHS). According to Jolles and Bogoch's Cochrane review, there are no long-term randomised control trials comparing different acetabular component positioning strategies with the approach chosen for THA. Because both of these surgical approaches have their benefits and drawbacks, orthopaedic surgeons are still debating which is ideal for primary THA. Objective : To evaluate the difference between the direct lateral and posterior approaches with respect to the functional outcome, component positioning, immediate postoperative pain, and patient satisfaction.