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September 10, 2025

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

Key Points

Minimally invasive approach resulted in significantly faster recovery and shorter hospitalization time compared to the standard approach.
The acetabular components in the minimally invasive group showed more anteversion with a notable p-value of 0.003.
Despite differences in recovery speed, there were no significant variances in complication rates or overall functional outcomes after one year.
Both techniques displayed comparable perioperative bleeding and operation time, suggesting similar levels of surgical risk.

Abstract

Target: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.

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