Total hip arthroplasty using the conjoined tendon-preserving posterior (CPP) approach, the modified posterior approach

Abstract Background The conjoined tendon-preserving posterior (CPP) approachis a modified posterior approach for total hip arthroplasty (THA) that preserves the short external rotator muscles and most ischiofemoral ligaments. The objective of the present study was to compare the short-term clinical outcomes, complications, and imaging evaluations of CPP and posterior approaches in THA. Methods This retrospective study included 72 patients: 30 patients with 36 hips who underwent THA with the CPP approach (CPP group) and 42 patients with 55 hips who underwent THA with the standard posterior approach (PA group). Assessment tools included operative times, blood loss, preoperative and postoperative one-year Harris Hip Scores (HHS), postoperative complications, and implant placement angles between the groups. Results The CPP approach had a significantly longer operative time and greater blood loss compare to the PA group. Preoperative and postoperative HHS were not significantly different between groups. Considering complications, the posterior approach group had one case each of dislocation and infection, and the CPP group had two cases of sciatic nerve palsy, but the difference was not significant. Cup anteversion, inclination and stem anteversion were not significantly different between groups. Conclusion Functional outcomes, complication rate, and implant placement angles were comparable between CPP and standard posterior approaches. The CPP approach has the potential to reduce dislocations, but attention should be paid to sciatic nerve palsy.