There was no major difference in the rate of complications .
Conclusions Short-term recovery favors limited incision over st and ard incision THA .
Background The literature comparing  limited incision and st and ard incision THAs  is confusing regarding whether limited incision THA improves short-term recovery without compromising long-term durability and survival .
Further , previously published meta-analyses can not conclude that limited incision THA is better .
With new data , we seek to discover if the answers now exist .
Purpose We used meta- analysis to compare surgical and hospitalization data , clinical outcomes , and complication rates , and thus ( 1 ) confirm whether limited incision THA is at least comparable to st and ard incision THA ; and ( 2 ) determine whether limited incision THA is an improvement over st and ard incision THA .
Randomized controlled trial of abductor muscle damage in relation to the surgical approach for primary total hip replacement: minimally invasive anterolateral versus modified direct lateral approach
Introduction Minimally invasive total hip arthroplasty ( THA ) is cl aim ed to be superior to the st and ard technique , due to the potential reduction of soft tissue damage via a smaller and tissue-sparing approach . As a result of the lack of objective evidence of fewer muscle and tendon defects , controversy still remains as to whether minimally invasive total hip arthroplasty truly minimizes muscle and tendon damage . Therefore , the objective was to compare the influence of the surgical approach on abductor muscle trauma and to analyze the relevance to postoperative pain and functional recovery . Material s and methods Between June 2006 and July 2007 , 44 patients with primary hip arthritis were prospect ively included in the study protocol . Patients underwent cementless unilateral total hip arthroplasty either through a minimally invasive anterolateral approach ( ALMI ) ( n = 21 ) or a modified direct lateral approach ( mDL ) ( n = 16 ) . Patients were evaluated clinical ly and underwent MR imaging preoperatively and at 3 and 12 months postoperatively . Clinical assessment contained clinical examination , performance of abduction test and the survey of a function score using the Harris Hip Score , a pain score using a numeric rating scale ( NRS ) of 0–10 , as well as a satisfaction score using an NRS of 1–6 . Additionally , myoglobin and creatine kinase were measured preoperatively , and 6 , 24 and 96 h postoperatively . Evaluation of the MRI images included fatty atrophy ( rating scale 0–4 ) , tendon defects ( present/absent ) and bursal fluid collection of the abductor muscle . Results Muscle and tendon damage occurred in both groups , but more lateral gluteus medius tendon defects [ mDL 3/12mth . : 6 (37%)/4 ( 25 % ) ; ALMI : 3 (14%)/2 ( 9 % ) ] and muscle atrophy in the anterior part of the gluteus medius [ mean-st and ard ( 12 ) : 1.75 ± 1.8 ; mean-MIS ( 12 ) : 0.98 ± 1.1 ] were found in patients with the mDL approach . The clinical outcome was also poorer compared to the ALMI group . Significantly , more Trendelenburg ’s signs were evident and lower clinical scores were achieved in the mDL group . No differences in muscle and tendon damage were found for the gluteus minimus muscle . A higher serum myoglobin concentration was measured 6 and 24 h postoperatively in the mDL group ( 6 h : 403 ± 168 μg/l ; 24 h : 304 ± 182 μg/l ) compared to the ALMI group ( 6 h : 331 ± 143 μg/l ; 24 h : 268 ± 145 μg/l ) . Conclusion Abductor muscle and tendon damage occurred in both approaches , but the gluteus medius muscle can be spared more successfully via the minimally invasive approach and is accompanied by a better clinical outcome . Therefore , going through the intermuscular plane , without any detachment or dissection of muscle and tendons , truly minimizes perioperative soft tissue trauma . Furthermore , MRI emerges as an important imaging modality in the evaluation of muscle trauma in THA
There was no major difference in the rate of complications .
Conclusions Short-term recovery favors limited incision over st and ard incision THA .
Background The literature comparing  limited incision and st and ard incision THAs  is confusing regarding whether limited incision THA improves short-term recovery without compromising long-term durability and survival .
Further , previously published meta-analyses can not conclude that limited incision THA is better .
With new data , we seek to discover if the answers now exist .
Purpose We used meta- analysis to compare surgical and hospitalization data , clinical outcomes , and complication rates , and thus ( 1 ) confirm whether limited incision THA is at least comparable to st and ard incision THA ; and ( 2 ) determine whether limited incision THA is an improvement over st and ard incision THA .