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Khalil Fendri1, Mohamed Amine Selmene1, Houssem Eddine Kraiem1

  • 1Department of Orthopaedic Surgery and Traumatology, Trauma Centre, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, 1006, Tunis, Tunisia.

La Tunisie Medicale
|March 17, 2025
PubMed
Summary

Comparing anterior and postero-lateral approaches for total hip arthroplasty (THA), this study found no definitive superiority. Surgeon and patient factors should guide the choice of THA surgical approach.

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty Research
  • Surgical Technique Comparison

Background:

  • Total hip arthroplasty (THA) is a common and effective procedure for hip joint restoration.
  • Multiple surgical approaches exist for THA, each with potential benefits and drawbacks.

Purpose of the Study:

  • To compare the anterior approach (AA) and postero-lateral approach (PLA) for primary THA.
  • Evaluation focused on postoperative care, functional outcomes, radiological results, and complications.

Main Methods:

  • Retrospective study of 200 primary THA patients (100 AA, 100 PLA).
  • Comparison of demographic, perioperative data, and functional scores (PMA, HHS) at 6 weeks and 6 months.
  • Assessment of implant positioning and postoperative complications.
Keywords:
Anterior approachCoxopathyHipPosterol-ateral approachSurgical approachTotal hip arthroplasty

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Main Results:

  • AA group: shorter operative time, less pain, reduced bleeding, shorter hospital stay, and better early functional scores.
  • AA group: superior acetabular cup positioning but increased risk of femoral stem undersizing and iatrogenic fractures.
  • PLA group: fewer skin/nerve complications but higher rates of prosthetic instability.

Conclusions:

  • Neither the anterior nor postero-lateral approach demonstrates clear superiority in primary THA.
  • The selection of the surgical approach should be individualized based on patient characteristics and surgeon preference.