International Orthopaedics

, Volume 36, Issue 3, pp 491–498 | Cite as

Reduced postoperative pain in total hip arthroplasty after minimal-invasive anterior approach

  • Sascha GoebelEmail author
  • Andre F. Steinert
  • Judith Schillinger
  • Jochen Eulert
  • Jens Broscheit
  • Maximilian Rudert
  • Ulrich Nöth
Original Paper



The development of minimal-incision techniques for total hip replacement with preservation of soft tissue is generally associated with faster rehabilitation, reduction of postoperative pain and increased patient comfort. The aim of this study was to compare a minimal-incision anterior approach with a transgluteal lateral technique for hip replacement surgery with respect to postoperative pain, consumption of rescue medication, length of hospital stay and time to reach a defined range of motion.


In this retrospective cohort study we investigated 100 patients with a minimal-incision anterior approach (group I) and 100 patients with a transgluteal lateral approach (group II) retrospectively undergoing unilateral hip replacement. The study variables were pain at rest and during physiotherapy, amount of rescue medication, the time to reach a defined flexion and time in hospital.


The patients of group I consumed less rescue medication (19.6 ± 6.9 mg vs. 23.6 ± 11.3 mg;  p = 0.005) and experienced less pain on the day of surgery (1.3 ± 1 vs. 2.3 ± 1.3, p = 0.0001) and the first postoperative day (0.41 ± 0.8 vs. 0.66 ± 1.1, p = 0.036). The time to reach the defined range of motion (6.4 ± 2 days vs. 7.4 ± 2.1 days; p = 0.001) and the length of hospital stay were shorter (10.2 ± 1.9 days vs. 13.4 ± 1.6 days; p = 0.0001) for group I. However, pain during physiotherapy was higher on the third and sixth through ninth days after surgery in comparison to group II (p = 0.001–0.013).


The implantation of a hip prosthesis through a minimal-incision anterior approach is successful in reducing postoperative pain and consumption of pain medication. Time to recovery and length of hospital stay are also influenced positively. Pain increases during physiotherapy, and may be mitigated by adopting limited weight bearing during the early postoperative period.


Postoperative Pain Pain Medication Anterior Approach Full Weight Bearing Postoperative Pain Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors report no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Sascha Goebel
    • 1
    Email author
  • Andre F. Steinert
    • 1
  • Judith Schillinger
    • 1
  • Jochen Eulert
    • 1
  • Jens Broscheit
    • 2
  • Maximilian Rudert
    • 1
  • Ulrich Nöth
    • 1
  1. 1.Department of Orthopaedic Surgery, König-Ludwig-HausJulius-Maximilians UniversityWürzburgGermany
  2. 2.Department of AnaesthesiologyJulius-Maximilians UniversityWürzburgGermany

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