A comparative study of the posterolateral and anterolateral approaches for isolated acetabular revision

Purpose

Although isolated revision of the acetabular component has become an increasingly common option for revision hip surgery, opinions differ regarding the ideal surgical approach for reducing postoperative instability. The purpose of this study was to compare the clinical and radiographic results of isolated acetabular revision performed using a posterolateral and an anterolateral approach.

Materials and methods

The authors retrospectively compared the clinical and radiographic results of isolated acetabular revision performed in 33 hips using a posterolateral approach with those performed in 36 hips using an anterolateral approach. All procedures were performed by a single surgeon and all patients received the same postoperative protocol. Mean duration of follow-up was 4.6 years (range 2–13.2).

Results

Mean postoperative Harris hip scores were similar in the posterolateral and anterolateral groups (86.5 and 87.2 points, respectively). In the entire series of 69 hips, 6 (9%) underwent re-revision of the acetabular component because of aseptic cup loosening in 4, recurrent dislocation in 1, and deep infection in 1. No significant difference was found between the two groups with respect to complication or re-revision rates, but the dislocation rate in the anterolateral approach group was significantly lower than that in the posterolateral group (0 vs. 12%, p = 0.047).

Conclusion

Isolated acetabular revision performed using an anterolateral approach seems to be the more viable option in selected patients, and in particular, it has a significantly lower postoperative dislocation rate than posterolateral acetabular revision.