A posterior approach to primary total hip arthroplasty with soft tissue repair

To determine whether repair of the posterior soft tissue structures affects dislocation rate, a comparison of the posterolateral approach with and without a posterior soft tissue repair in primary total hip arthroplasty was done. Between January 1993 and December 1998, 250 consecutive primary total hip arthroplasties (220 patients) without a posterior soft tissue repair followed by 96 consecutive primary total hip arthroplasties (83 patients) with a posterior soft tissue repair in the posterolateral approach were done. With the exception of a posterior soft tissue repair, all surgical procedures were done in the same manner. A dislocation rate of 6.4% in 250 hips without a posterior soft tissue repair in the posterolateral approach was reduced to 1% in 96 hips with a posterior soft tissue repair. The results were statistically significant. The current results indicate that the posterior structures should be preserved as much as possible and repaired to reduce dislocation in the posterolateral approach.