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1Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol. 2 Avon Orthopaedic Centre, Southmead Hospital North Bristol NHS Trust.
A SYSTEMATIC REVIEW AND META-ANALYSIS OF ADVERSE EVENTS FOLLOWING THE POSTERIOR AND LATERAL APPROACHES TO TOTAL HIP ARTHROPLASTY James R
1,2 Berstock ,
Ashley W
1,2 Blom ,
Andrew D
1 Beswick
1Musculoskeletal
Research Unit, School of Clinical Sciences, University of Bristol 2 Avon Orthopaedic Centre, Southmead Hospital North Bristol NHS Trust
Background The 10th NJR report reveals that 33% of primary hip arthroplasty surgery cases are performed via the lateral approach, whereas 61% of cases are performed via the posterior approach. Despite this, evidence to inform the choice of surgical approach is lacking.
Approaches used for primary THR
Lateral
Posterior
> 27,000 1° THRs
> 50,000 1° THRs
Posterior
Lateral
Other
Data from 10th NJR Report of England, Wales and Northern Ireland 2013
Methods Extensive searches of the literature published in any language before February 2013. Randomised, quasirandomised trials and prospective cohort studies comparing the posterior with the direct lateral approach were included.
Results
Conclusions
We identified three randomised controlled trials and three prospective studies involving 559 participants.
In contrast to conventional teaching, it appears that the posterior approach may confer a reduction in dislocation risk, although the odds ratio did not reach statistical significance. The transosseous capsulotendinous repair of the short external rotators may account for this difference.
The posterior approach conferred a statistically significant reduction in: • Trendelenburg gait (odds ratio 0.31, P
