title: Anterolateral mini-invasive versus posterior mini-invasive approach for primary total hip replacement. Comparison of exposure and implant positioning.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'Orthopédie et de Traumatologie CHU Rangueil, 1, avenue Jean Poulhès TSA 50032, 31059 Toulouse, Cedex 9, France. jean-michel.laffosse@wanadoo.fr
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Laffosse
authors.forename: Franck
authors.initials: F
authors.lastname: Accadbled
authors.forename: François
authors.initials: F
authors.lastname: Molinier
authors.forename: Philippe
authors.initials: P
authors.lastname: Chiron
authors.forename: Bensafi
authors.initials: B
authors.lastname: Hocine
authors.forename: J
authors.initials: J
authors.lastname: Puget
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000453:epidemiology / Q000601:surgery; D010024:Osteoporosis / Q000453:epidemiology; D011446:Prospective Studies