title: Early complications of primary total hip arthroplasty in the supine position with a modified Watson-Jones anterolateral approach.
abstract: BACKGROUND
  For total hip arthroplasty (THA), minimally invasive surgery (MIS) has been developed to reduce incision length, muscle damage, and a shorter hospital stay. However, reduced exposure of anatomical landmarks may result in technical errors and inferior implant survivorships. The aim of this study was to report the short-term results and clinical complications of primary MIS THA in the supine position.
  
  
  METHODS
  A consecutive series of 103 patients who underwent MIS cementless THA with a modified Watson-Jones anterolateral approach (AL) were enrolled. Outcomes data were reviewed at a minimum of 12 months following the procedure. Clinical evaluations were made using the Merle d'Aubigne and Postel hip score. The results of these procedures were retrospectively compared with those of a historical series of 98 total hip arthroplasties that had been performed by the same surgeon with use of a posterolateral approach (PL).
  
  
  RESULTS
  In the MIS AL THA group, intraoperative fracture was observed in 6 hips; 3 in greater trochanter and 3 in calcar femoral. One hip was subjected to irrigation because of postoperative infection was suspected. In the PL group, intraoperative fracture was demonstrated in 4 hips in calcar femoral. No postoperative dislocation and no pulmonary embolism or nerve paralysis was observed in both groups.
  
  
  CONCLUSIONS
  The MIS AL THA did not show a clinically relevant superior outcome compared with the PL THA. When performing MIS AL THA, special attention should pay for prevention of greater trochanter fracture.
authors.affiliation: Department of Orthopaedic Surgery, Itami City Hospital, Itami 664-8540, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakai
authors.affiliation: Department of Orthopaedic Surgery, Itami City Hospital, Itami 664-8540, Japan.
authors.forename: Naxin
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, Itami City Hospital, Itami 664-8540, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fudo
authors.affiliation: Department of Orthopaedic Surgery, Itami City Hospital, Itami 664-8540, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Mohri
authors.affiliation: Department of Orthopaedic Surgery, Osaka Police Hospital, Osaka 543-0035, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kakiuchi
keywords: Anterolateral approach; Complication; Supine position; Total hip arthroplasty