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Anterior vs Posterior
There seems
to be a greater risk of nerve damage using the
anterior approach due to the exposure of the
sciatica, but the conclusion was that with
attention to detail it was fine to use the
anterior approach.
There was a
bone scanning study done to study the
vascularity of the posterior approach post
surgery to find out if the posterior approach
damages the blood supply. This study was done
by Beule.
They found
that disruption of the blood supply was
temporary only. Study was done 7/97 - 1/31/02
Only 4 out
of 10,000 resurfacings ended up with AVN. With
the bone scan they found that vascularity of the
femoral head at 2 years was normal. 75% able to
see through the metal with the bone scan.
McMahon
study on approaches all showed vascularity after
posterior approach after 2 years. He concluded
that bone scanning was a valid method for
detecting vascularity.
Corr 2008
will publish a study of influence of surgical
approaches.
The
results showed the survivorship to be 98%
Anterior and 98% Posterior.
So the
conclusion was that there is no difference
between the two approaches and that the
vascularity is no different using one approach
over the other.
On a side
note, McMinn and Treacy both advocate the
posterior approach and both voiced this at the
conference.
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