Anterior vs Posterior Surgical Approaches
Miami Orthopedic Conference 2007
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.