title: A systematic review and meta-analysis of complications following the posterior and lateral surgical approaches to total hip arthroplasty.
abstract: BACKGROUND
  Total hip arthroplasty is one of the most commonly performed orthopaedic procedures. Despite this, medical evidence to inform the choice of surgical approach is lacking. Currently in the UK, the two most frequently performed approaches to the hip are the posterior and the direct lateral.
  
  
  METHODS
  This systematic review was performed according to Cochrane guidelines following an extensive search for prospective controlled trials published in any language before January 2014. Of the 728 records identified from searches, 6 prospective studies (including 3 randomised controlled trials) involving 517 participants provided data towards this review.
  
  
  RESULTS
  Compared with the lateral approach, the posterior approach conferred a significant reduction in the risk of Trendelenburg gait (odds ratio [OR]: 0.31, p=0.0002) and stem malposition (OR: 0.24, p=0.02), and a non-significant reduction in dislocation (OR: 0.37, p=0.16) and heterotopic ossification (OR: 0.41, p=0.13). Neither approach conferred a functional advantage. We draw attention to the paucity of evidence and the need for a further randomised trial.
authors.affiliation: North Bristol NHS Trust, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Berstock
authors.forename: A W
authors.initials: AW
authors.lastname: Blom
authors.forename: A D
authors.initials: AD
authors.lastname: Beswick
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods*; D006622:Hip Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome