Anterolateral Approach Might Be Superior to Posterolateral Approach in Controlling Lower Limb Discrepancy for Special Total Hip Arthroplasty Patients

Abstract

Objectives: Variable approaches for total hip arthroplasty (THA) are promoted but investigations of associations between the approaches and the postoperative lower limb discrepancy (LLD) are limited. We intended to compare the efficacy between the anterolateral approach (ALA) and posterolateral approach (PLA) in controlling of postoperative LLD. Methods: Two retrospective cohorts were established including patients undergone unilateral primary THA. Preoperative and latest follow-up radiographs were compared and evaluated. Two hundred and sixty patients (140 females and 126 males; aged 46.70 ± 13.62 years) were recruited with around 20 months follow-up postoperatively. Results: Univariate analysis identified lower postoperative LLD, lower postoperative acetabular offset and lower hospital costs in the ALA group than in the PLA group (p＜0.01), however, the femoral and global offset and length of stay (LOS) are comparable between (p > 0.05). Multivariable liner regression revealed that PLA, preoperative LLD, developmental dysplasia of the hip and aseptic avascular necrosis are major contributors to the postoperative LLD (p<0.05). Conclusions: This study illustrates that the ALA might be superior to the PLA in controlling the postoperative LLD among some of the THA patients. Both ALA and PLA are comparable in regard to femoral and offset and LOS.