A MODIFIED DIRECT LATERAL APPROACH FOR PRIMARY AND REVISION TOTAL HIP-ARTHROPLASTY - A PROSPECTIVE ANALYSIS OF 453 CASES

A prospective analysis of 453 consecutive primary and revision total h ip arthroplasties (THAs) were reviewed. The modified direct lateral ap proach was used in 306 of 319 (96%) primary THAs and 115 of 134 (86%) revision cases for a total of 421 of 453 (93%) procedures. There were three dislocations in the revision group of patients. All three patien ts had at least two previous arthroplasties prior to their index surge ry and at the time of surgery were noted to have very poor tissue qual ity, making the repair difficult. There were no postoperative dislocat ions in the primary THA group, with an overall dislocation rate of 0.7 %. The incidence of postoperative Limp in the primary THA group was 18 %. The overall incidence, including revision surgery, was 27%. The pre sence of a persistent limp after initial rehabilitation was dependent on the number of previous surgeries, leg-length discrepancy greater th an 2.7 cm, revision THA requiring a proximal femoral allograft, and pr eexisting deformities. Limp was therefore believed not to be related t o the use of the modified direct lateral approach.