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A Comparative Study of Functional Outcome Following Total Hip Replacement by Posterolateral and Anterolateral
Sunil Parmar1, Santosh Mishra1, Vinod Kumar Rawat2
1Department of Orthopaedics, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
Journal of Orthopaedic Case Reports
|July 10, 2026
Summary
The anterolateral approach for total hip arthroplasty (THA) in avascular necrosis (AVN) patients shows better early functional recovery and pain relief compared to the posterolateral approach. Both surgical methods are safe and effective for THA in AVN treatment.
Area of Science:
- Orthopedic Surgery
- Hip Reconstruction
- Musculoskeletal Disorders
Background:
- Total hip arthroplasty (THA) is a primary treatment for advanced avascular necrosis (AVN) of the femoral head.
- Surgical approach selection (anterolateral vs. posterolateral) for THA in AVN remains a subject of debate.
- Understanding functional outcomes and complications is crucial for optimizing patient care.
Purpose of the Study:
- To compare functional outcomes, pain relief, and complication rates between anterolateral and posterolateral THA approaches in AVN patients.
- To evaluate the efficacy of each surgical technique in improving patient quality of life.
- To provide evidence-based guidance for selecting the optimal surgical approach.
Main Methods:
- Prospective-retrospective observational study involving 60 patients with Stage III and IV AVN of the femoral head.
- Patients were divided into anterolateral (n=29) and posterolateral (n=31) groups.
- Functional outcomes assessed using Harris Hip Score (HHS) and pain using Visual Analog Scale (VAS) at 1 and 6 months post-operatively.
Main Results:
- Both THA approaches demonstrated significant improvements in HHS and reductions in VAS scores over time (P < 0.001).
- The anterolateral approach yielded significantly higher HHS and lower VAS scores at 1 and 6 months compared to the posterolateral approach (P < 0.05).
- Post-operative complications were infrequent and comparable between the two surgical groups.
Conclusions:
- Both anterolateral and posterolateral approaches are safe and effective for THA in treating femoral head AVN.
- The anterolateral approach offers superior early functional recovery and pain relief.
- Surgical approach selection should consider surgeon expertise and patient-specific factors.
