A Modified Transgluteal Approach Sparing Abductor Function in Total Hip Arthroplasty Results in a Low Postoperative Dislocation Rate: A Retrospective Study of Short- and Long-Term Outcomes

Background A modified transgluteal approach in total hip arthroplasty (THA) can be utilized to preserve abductor muscle function and reduce dislocation rate. We present a study evaluating outcomes for a modified transgluteal approach using a validated patient-reported outcome measure (PROM) tool, the Oxford Hip Score (OHS). Methods This was a retrospective single-centre study over a four-year period. Short-term data was collected including intraoperative and postoperative complications, length of stay (LOS) in the hospital, and time from operation to mobilising independently. One year of data was collected, including plain radiograph findings and the incidence of Trendelenburg gait. Patients were contacted at a mean time of 2.7 years post-operatively so that OHS could be conducted. Results A total of 100 patients were identified within the inclusion criteria. The mean LOS for all patients was 2.8 days. The mean time from operation to mobilising independently without walking aids was 4.9 weeks. At the one-year follow-up, there was satisfactory radiographic assessment in 100% of patients. The mean OHS was 45.5 at 2.7 years, indicating satisfactory joint function in all patients. Conclusion This study supports the use of the modified transgluteal approach in THA, showing favourable outcomes in the time from operation to cessation in the use of walking aids, LOS and OHS. We report zero cases of Trendelenburg gait at the one-year follow-up and no dislocations at the three-year follow-up. Further studies are required to compare the outcomes of TGA to other approaches in THA.