Comparison of complications after transtrochanteric and posterolateral approaches for primary total hip arthroplasty

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Abstract

For this study, 100 total hip arthroplasties (THAs) in a transtrochanteric approach group and 100 THAs in a posterolateral approach group were performed at one university hospital by a single, experienced surgeon. These THAs were then followed up for a minimum of 2 years to determine the incidence of postoperative complications. In our study, patients undergoing primary THA by the posterolateral approach were 18.4 times more likely to be complication free than patients in whom the transtrochanteric approach was used. This benefit, combined with a shortened surgical time, decreased blood loss, and technical ease, shows the advantages of the posterolateral approach for THA.

Section snippets

Materials and methods

The demographic and clinical data from patients who underwent primary THA performed by a single, experienced surgeon (Nas S. Eftekhar, MD) between December 1987 and December 1995 were studied. All surgeries were performed at a single university hospital (Columbia Presbyterian Medical Center, New York, NY). Prospective collection of all data was possible with the use of the Hip Assessment Record, which included the hip examination and grading of hips both preoperatively and postoperatively

Transtrochanteric approach group

The transtrochanteric group consisted of 100 THAs in 90 patients. The mean age and standard deviation for this group at the time of THA was 63 ± 11.9 years (range, 19–88 years). Fifty-four (60%) of these patients were women and 36 were men. The average patient in this group weighed 69.1 kg (range, 45.9–103.5 kg) and was 168.0 cm in height (range, 147.3–185.4 cm); corresponding to a mean body mass index of 24.9 (STD, 3.8). Fifty-four of the 100 THAs (54%) were performed on the left hip while the

Discussion

Total hip arthroplasty has long been an accepted orthopaedic procedure capable of providing high-quality results and significant patient satisfaction. Obtaining these results relies partly on the surgeon’s ability to achieve the necessary surgical exposure. The transtrochanteric approach pioneered by Charnley provides an extensive surgical exposure and allows for advancement of the trochanter and proper soft tissue tensioning, aids the accurate orientation of prosthetic implants, and

Acknowledgements

The authors wish to thank Louis U. Bigliani, M.D. for his leadership and guidance and Maureen Sheahan for her help with logistics and manuscript preparation.

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    No benefits or funds were received in support of this study.

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