The anterolateral supine approach is beneficial after total
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Muscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping. This study aimed to assess and compare muscle volume and degeneration after THA using the posterolateral (PL) and anterolateral (AL) approaches.

64 hips in 64 patients who underwent primary THA were retrospectively analyzed. Patients were segregated into the PL group (35 hips) and AL group (29 hips) for evaluating pre- and postoperative muscle volumes and degeneration around the hip. Computed tomography (CT) examinations were performed preoperatively and 6 months post THA. The muscle volume and Hounsfield units (HU) of the gluteus maximus (G-max), gluteus medius (G-med), tensor fasciae latae, internal obturator muscle, and external obturator muscle were measured.

Results:
--In the PL group, the postoperative muscle volume of the G-max significantly increased than the preoperative muscle volume. In contrast, the postoperative muscle volume of the internal obturator muscle was significantly lower than the preoperative muscle volume.

--The postoperative HU of the internal and external obturator muscles were significantly lower than the preoperative HU.

--In the AL group, the postoperative muscle volumes of the G-max, G-med, and tensor fasciae latae significantly increased than their preoperative muscle volumes.

--The postoperative HU of the G-med and tensor fasciae latae were significantly higher than the preoperative HU values.

In conclusion, the PL approach can lead to internal and external obturator degeneration. For recovering the G-med, tensor fasciae latae, and internal obturator muscle, the AL approach is more effective than the PL approach.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02291-y
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