Comparison of Hip Approaches - Paul Jairaj 12/9/2000

UNWIN          1994    Ann R Coll Surg Engl

Unwin AJ. Thomas M

Dislocation after hemiarthroplasty of the hip: a comparison of the dislocation rate after posterior and lateral approaches to the hip.

Ann R Coll Surg Engl 1994 Sept;67(5):327-9

Compared three month dislocation rate of hemis between posterior and direct lat approach and found significant overall difference between them (9% vs 3.3%).However rate varied depending on grade of surgeon with no difference in dislocation rate for senior registrars but there was for regs and shos where

differences in dislocation rate for post and direct lat was 8.4% vs 3.3% and 14.2% vs 3.6% resp

they state post approach should be abandonded by surgical trainees early in their careers due to high mortality of dislocated hemiarthroplasty.

Retrospective "85-"92. 4 centre trial. Good numbers 2906/3118 consecutive patients. Only 3 month follow up.different direct lateral approaches.

HEDLUND      1995    J Arthroplasty

Hedlund U. Hybbinette CH. Fredlin H.

Influence of surgical approach on dislocations after Charnley hip arthroplasty

Journal of Arthroplasty 1995 Oct;10 (5):609-14,

Dislocation rate within 2 years of sugery did not alter with approach, however higher risk in patients with osteoarthritis. Noted higher earlier disloc rate with post approach (but no increase in revision rate)and higher disloc rate with less experienced sugeons.

Retrospective "79-"91.2 center trial.Good numbers 3199. 2 year follow up.