Anterolateral mini-invasive versus posterior mini-invasive approach for primary total hip replacement. Comparison of exposure and implant positioning

Introduction We conducted a prospective study to compare the exposure and implant positioning in primary total hip replacement through the anterolateral minimally invasive (ALMI) approach versus the posterior minimally invasive (PMI) approach. Materials and methods We applied these techniques to 2 consecutive groups (33 and 43 patients, respectively) comparable preoperatively. All the patients received the same cementless stem and acetabular component. Results There were neither significant difference in femoral or acetabular component positioning nor in limb-length discrepancy. Acetabular exposure was easy through the ALMI approach. Femoral exposure was more difficult as fractures of the trochanter and femoral perforation in our study show. Conclusion For us, exposure and implant positioning through the ALMI approach and the PMI approach are comparable and reliable. However, we recommend caution during the initial learning curve in osteoporotic patients due to the higher rate of peroperative complications for the ALMI approach.