Objective: In recent years, the paradigm of surgical approaches for total hip arthroplasty (THA) has evolved, with portal-assisted techniques emerging as a promising avenue for increasing precision and minimizing invasiveness. The purpose of this study was to compare early experience with the Microport anterior percutaneously assisted total hip arthroplasty (MAP) system, with the established AMIS direct anterior approach (DAA).
Material And Methods: A retrospective chart analysis was performed on 200 consecutive patients who underwent DAA or MAP at our institution in 2022. The research was conducted in accordance with the Declaration of Helsinki (as revised in 2013), and was approved by the institutional review board of the University Duisburg-Essen (23-11274-BO).
Results: Two hundred patients were enrolled (100 DAA and 100 MAP; time to follow-up 1.7 years ±88 days). The mean operative time was 81 minutes (MAP) and 67 minutes (DAA, p>0.05). The mean cup tilt angle was 39° (MAP) and 40° (DAA; p>0.05). The mean cup anteversion angle was 13° (MAP) and 16° (DAA; p>0.05). The mean postoperative hemoglobin (Hb) decrease was 2.6 mg/dL ±0.9 mg/dL (MAP) and 2.5 mg/dL ±0.9 mg/dL (DAA; p>0.05). No major complications were documented in any of the 200 cases during the observation period. Additional screw fixation was performed in 7 cases and hybrid stem cementation was performed in 3 cases due to lack of rotational stability. All 10 cases were in patients with DAA. In only one of the 200 cases, two units of RBC were transfused postoperatively in a DAA case after a postoperative decrease of 5.7 mg/dL Hb.
Conclusion: Anterior Path has been demonstrated to provide reliable results, despite the presence of a steep learning curve. The employment of a working cannula has been shown to enhance the surgeon's perspective during the preparation of the acetabulum. In relation to skin incision, the bikini line incision, which is regarded as advantageous due to its alignment with the cleavage lines, has been identified as a notable benefit that is acknowledged by the patient.
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