THE EFFECT OF SURGICAL APPROACH ON FUNCTION AND QUALITY OF LIFE FOLLOWING PRIMARY TOTAL HIP ARTHROPLASTY

Abstract

The two most common surgical approaches used in primary hip arthroplasty are the anterolateral and posterolateral approach. While both approaches have potential advantages and disadvantages in comparison to the other, there are no reports with sufficient power to compare their effect on post-operative function and quality of life. This prospective cohort study evaluates and compares the independent effect of surgical approach on function and quality of life among patients who have received their total hip arthroplasty through one of these techniques. Results suggest that there is no significant difference in function or quality of life among these respective cohorts.

The purpose of this study was to evaluate and compare the effect of anterolateral versus posterolateral approach on function and quality of life following primary total hip arthroplasty.

There is no significant difference in outcome as a result of surgical approach. Significance: This is the first report with sufficient power to evaluate and compare outcomes of these two approaches among high volume hip surgeons. This study suggests that surgeons need not worry that the anterolateral or posterolateral approach may compromise patient function or generic quality of life more-so than the alternative approach.

Univariate and regression analyses demonstrate similar outcomes on WOMAC, Oxford-12, SF-12 and satisfaction among cohorts of patients receiving the anterolateral or posterolateral approach for primary total hip arthroplasty.

A prospective evaluation of function and quality of life outcomes was performed on patients receiving the anterolateral or posterolateral approach for primary hip arthroplasty. All participating surgeons were considered to be high volume arthroplasty surgeons. One hundred and sixty procedures were followed and provided complete outcomes data including WOMAC, Oxford, SF-12, and satisfaction scores. Univariate analyses demonstrated no differences among the two cohorts with regards to baseline variables. Regression analyses were performed for the outcome measures with surgical approach treated as an independent covariate while controlling for other potential confounders. The results suggest that there is no independent effect of surgical approach on patient reported outcomes. This suggests that the surgeon should continue to employ the approach which is the most familiar and most likely to result in consistent results in their clinical environment.