Comparison of the Effectiveness of the Minimally Invasive Approach with Preserved Piriformis Muscle with the Standard Posterolateral Approach in Total Hip Arthroplasty

Objective: The purpose of this study is to determine if the minimally invasive posterolateral approach with preserved piriformis muscle is superior to the conventional technique in total hip arthroplasty.

Methods: A prospective, randomized study was carried out where the sample was made up of 200 patients who underwent primary total hip arthroplasty between September 2019 and March 2021 with a minimum follow-up of one year at the Beijing Jishuitan Hospital. Perioperative bleeding, postoperative pain, recovery time, component orientation, size, and fit, frequency of complications, and functional outcome were evaluated.

Results: No significant differences were found between the groups in terms of perioperative bleeding, operation time. Recovery speed was significantly higher with the minimally invasive posterolateral approach, as earlier onset of ambulation and shorter hospital stays were detected. In the minimally invasive surgery group, the acetabular components were more anteverse, the size of the acetabular component and femoral head was smaller, the adjustment technique was predominantly press fit, and the Visual Analogue Scale score was significantly lower at 48 hours. postoperative No differences were found in terms of the frequency of complications or functional results at one year.

Conclusions: The minimally invasive approach with preserved piriformis muscle achieves faster recovery and early pain relief compared to the conventional approach, with a functional result similar to that of conventional techniques in 12 weeks

Objective: The purpose of this study is to determine if Mis-PLA is superior to the conventional technique in total hip arthroplasty.

Methods: A prospective, randomized study was carried out where the sample constitutes 200 patients who underwent primary THA between september 2019 and march 2021 with a minimum follow-up of one year. Perioperative bleeding, postoperative pain, recovery time, component orientation, size, and fit, complication rate, and functional outcome were evaluated.

Results: No significant differences were found between the groups in terms of perioperative bleeding, operation time. The speed of recovery was significantly higher with the minimally invasive posterolateral approach, as an earlier onset of ambulation and a shorter hospitalization time were detected. In the Mis-PLA group, the acetabular components were more anteversion (p = 0.003), the size of the acetabular component and femoral head was smaller, the fitting technique was predominantly press-fit, the Visual Analogue Scale was significantly lower at 48 hours postoperatively. No differences were found in terms of complication rate or functional outcome at one year.

Conclusions: The Mis-PLA achieves faster recovery and early pain relief compared to the conventional approach without compromising surgical time, component orientation, or increasing the rate of complications, with functional results similar to conventional techniques in 12 weeks.

Keywords: Total hip arthroplasty; Posterolateral approach; Minimally invasive surgery; Mis-PLA