A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

Abstract

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p < 0.05 for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

The Röttinger approach for total hip arthroplasty: technique, comparison to the direct lateral approach and review of literature

“…Generally, hip approaches can be broadly divided into three main categories depending on the anatomical relationship to the greater trochanter; anterior, lateral, and posterior approaches (7,9,10). Additionally, intermediate approaches in-between any two of the above have been established (10)(11)(12)(13). Overall, posterior approaches provide wider exposure and spare the abductors muscles.…”

Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

“…We have also found that age ≥ 55 years and preoperative degenerative Tönnis stage II were independent risk factors for future THA conversion. With our considerable experience in THA via the modified Watson-Jones approach [26, 27], we were able to perform the osteochondroplasty on the head-neck junction with a small intermuscular interval, and use arthroscopic technique to manage the labral and cartilage injuries in patients with cam-type FAI.…”