Differences in muscle trauma quantifiable in the laboratory between the minimally invasive anterolateral and transgluteal approach.
BACKGROUND
In Europe the minimized transgluteal (TG) and anterolateral (AL) approaches are increasingly preferred in hip arthroplasty (THA).


METHODS
The present investigation determined which of these approaches causes the least muscle trauma. Forty patients who received a THA were enrolled in this prospective randomized study. Muscle trauma was quantified by perioperatively measuring the serum concentration of skeletal troponin I (sTnI). The Harris hip score (HHS) was determined before and 12 months after surgery.


RESULTS
It increased significantly in all patients without being different between the groups (AL, 48.2→83.6; TG, 50.8→85.9). Patients in the TG group had a higher sTnI than those in the AL group 24 h postoperatively (21.6 vs. 10.9 nmol/ml, p = 0.022). The AL approach results in a reduced muscle traumatization compared with the TG approach, without this being revealed by the HHS.
Matziolis
Doerte
D
Orthopädische Klinik, Centrum für Muskuloskeletal Chirurgie, Charité, Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Wassilew
Georgi
G
Strube
Patrick
P
Matziolis
Georg
G
Perka
Carsten
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries*; D011446:Prospective Studies; D019210:Troponin I / Q000097:blood
D019210:Troponin I