A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

Abstract EN

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking.

Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied.

The medical records, radiographic parameters, and functional outcomes were collected prospectively.

All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach.

THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05 for all four) than the modified WJ approach.

The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups.

However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period.

Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years.

A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.