Transgluteal vs. Anterior and Posterior Approaches for Porcine Model of Irreparable Acetabular Labral Tear: A...

To compare the surgical feasibility and safety of three approaches (anterior, transgluteal, posterior) for constructing a porcine model of irreparable acetabular labral tear.

After a cadaveric anatomical exploration in two pigs to define feasible corridors, 36 male Chinese miniature pigs were randomized (1:1:1) to anterior, transgluteal, or posterior approaches for model construction and labral reconstruction. Primary intraoperative outcomes were blood loss, operative time, and a 0-10 surgical exposure score; postoperative complications and survival were assessed over 3 months.

The anterior approach showed greater blood loss and longer operative time than posterior and transgluteal (both p < 0.001), while exposure was worst with anterior (p < 0.001) and only trended better with transgluteal versus posterior (p = 0.056). Postoperative events included sciatic nerve-related claudication (4/12 posterior), acetabular chondral lesions (3/12 anterior), and poor wound healing (4/12 anterior; 2/12 posterior). One-month survival was lower in anterior versus transgluteal (p = 0.025), with most deaths within 2 weeks; 2- and 3-month survival were also lower for anterior versus transgluteal (p = 0.026; p = 0.011). At 2 months, survival was lower in anterior versus posterior (p = 0.011).

The transgluteal approach appears to be a relatively safe and effective option for constructing porcine hip models; nevertheless, conclusions should be interpreted with caution given the undetermined mortality etiology in the anterior group.