Differences in muscle trauma quantifiable in the laboratory between the minimally invasive anterolateral and transgluteal approach.

INTRODUCTION: In Europe the minimized transgluteal (TG) and anterolateral (AL) approaches are increasingly preferred in hip arthroplasty (THA).

METHOD: The present investigation determined which of these approaches causes the least muscle trauma. Forty patients who received a THA were enrolled in this prospective randomized study. Muscle trauma was quantified by perioperatively measuring the serum concentration of skeletal troponin I (sTnI). The Harris hip score (HHS) was determined before and 12 months after surgery.

RESULTS: It increased significantly in all patients without being different between the groups (AL, 48.2→83.6; TG, 50.8→85.9). Patients in the TG group had a higher sTnI than those in the AL group 24 h postoperatively (21.6 vs. 10.9 nmol/ml, p = 0.022). The AL approach results in a reduced muscle traumatization compared with the TG approach, without this being revealed by the HHS.