The minimally invasive anterolateral approach promotes faster rehabilitation than the lateral approach after total hip arthroplasty: a retrospective case-control study of Asian patients

Abstract

Background: This study sought to compare the differences in the early postoperative clinical outcomes of Asian patients who underwent total hip arthroplasty (THA) using the minimally invasive anterolateral approach (MIAL) or the lateral approach (LA). Methods: This retrospective study examined the data of 80 consecutive patients who underwent THA between January 2020 and September 2021. Of the patients, the MIAL was used in 41 patients, and the LA was used in 39 patients. The modified Harris Hip Score (mHHS) survey and the 36-item Short-Form Health Survey (SF-36) were administered during the first 3 postoperative months. Surgical parameters, the time it took to complete indoor self-care activities, and complications were also analyzed. Results: No significant differences were found in the patients’ baseline characteristics. At 5 days postoperatively, the mHHS, visual analogue scale (VAS) score, and positive rate of the Trendelenburg test were significantly better in the MIAL group than the LA group. The time it took to engage in indoor self-care was significantly shorter in the MIAL group than the LA group. At 6 weeks postoperatively, the results of the mHHS and the majority of the SF-36 items were significantly higher in the MIAL group than the LA group. At 12 weeks postoperatively, there was no statistical difference in the mHHSs between the two groups; however, the scores for most SF-36 items, except the vitality and emotional role items, were significantly higher in the MIAL group than the LA group. The complication rates were comparable between the two groups. Conclusions: The MIAL facilitated quicker recovery for Asian patients, who showed earlier indoor self-care, better hip function, and better health related quality of life; however, the complication rates of the MIAL and LA groups were comparable.