Total hip arthroplasty performed with a tissue-preserving technique using superior capsulotomy

Area of Science:

• Orthopedic Surgery
• Arthroplasty Research
• Minimally Invasive Techniques

Background:

• Total hip arthroplasty (THA) aims to restore function and reduce pain.
• Traditional surgical approaches can involve significant muscle disruption.
• Minimally invasive techniques are being developed to improve patient recovery and reduce complications.

Purpose of the Study:

• To evaluate the clinical outcomes and safety of a novel tissue-sparing posterior superior (TSPS) approach in THA.
• To compare the TSPS approach with a standard posterolateral approach regarding recovery speed, clinical scores, and complication rates.
• To determine if the TSPS technique preserves abductor and short rotator muscles and allows for posterior capsule repair.

Main Methods:

• A retrospective observational study comparing two cohorts: 130 hips with a standard posterolateral approach and 132 hips with the TSPS approach.
• Patients were assessed preoperatively and postoperatively at one month (Harris Hip Score only), three months, one year, and four years using the Harris Hip Score (HHS) and Western Ontario and McMaster Universities index (WOMAC).

Main Results:

• The TSPS group demonstrated significantly better early functional recovery, evidenced by higher HHS and WOMAC scores up to one year post-surgery (p < 0.05).
• No significant differences in HHS or WOMAC scores were observed between the TSPS and standard groups at the four-year follow-up (p = 0.564 and p = 0.796, respectively).
• No major adverse events were reported in either surgical group, indicating comparable safety profiles.

Conclusions:

• The TSPS approach provides superior early clinical outcomes and faster recovery in the initial year after total hip arthroplasty.
• While safe and reliable, the early benefits of the TSPS technique are not sustained long-term.
• Mid-term clinical outcomes and complication rates were similar between the TSPS and standard posterolateral approaches at four years.