Posterior soft tissue repair in total hip arthroplasty: a randomized controlled trial

Posterior soft tissue repair is a well-known procedure in total hip arthroplasty (THA). Many reports have shown the advantage of posterior soft tissue repair in reducing the dislocation rate; however, we were unable to find any randomized trials in the literature. This article describes a randomized trial performed to investigate the effect of posterior soft tissue repair on the dislocation rate after 298 THAs in 291 patients. Preoperatively, patients were randomized into 2 groups: posterior soft tissue repair after insertion of the components, or no posterior soft tissue repair. One year postoperatively, 12 patients had died and 10 were lost to follow-up, leaving 276 THAs in 265 patients for analysis. A posterior soft tissue repair had been performed in 134 and no repair in 141 THA. One year postoperatively, 3 dislocations (2%) had occurred in the repaired group and 7 in the unrepaired group (5%); the difference was not significant (P=.3). There were 2 sciatic nerve palsies in the repaired group, 1 of which was directly related to the posterior soft tissue repair.In this randomized, controlled trial of 276 THAs followed for 1 year, there was a tendency for a lower dislocation rate, although not statistically significant, when a posterior repair was performed. If reattaching the posterior tendons, it should be performed with caution with respect to the sciatic nerve.