ArticleInternational orthopaedics2025
Trans-osseous repair of the posterior structures is superior to direct suturing in posterior approach total hip arthroplasty: a comparative cadaveric study.
Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Optimizing initial biomechanical strength ("Time Zero") of posterior repair in total hip arthroplasty: a biomechanical comparison of suture materials and knot configurations.Archives of orthopaedic and trauma surgery · 2026Article
- Capsular reconstruction versus excision in anterolateral total hip arthroplasty: a prospective randomized controlled trial.International orthopaedics · 2026Article
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Authors and funding
7 authors.
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Abstract
purposeDislocation after total hip arthroplasty (THA) via the posterior approach remains a serious complication. This cadaveric study compared two soft tissue repair techniques-trans-osseous and direct suturing-regarding their effect on dislocation torque and angle.
methodsTen hips from five fresh-frozen cadavers were used. A Posterior approach identified the short external rotators. Following standard THA, each limb was mounted on a motorized torque wrench. Hips were tested first with no posterior repair (NPR), then with either transosseous or direct repair techniques. Dislocation torque and angle were recorded, with each hip serving as its own control.
resultsPosterior repair significantly increased the force required for dislocation compared to NPR (mean 9.12 Nm vs. 2.73 Nm; p = 0.004). Trans-osseous repair led to a 4.41-fold increase in torque (p = 0.04), and direct repair a 2.47-fold increase (p = 0.03), with a significant difference between the two (p = 0.016). The dislocation angle increased with repair (mean 54.6° vs. 45.1°; p = 0.09), though not significantly. Trans-osseous and direct repairs increased the angle by 1.70× and 1.18×, respectively.
conclusionPosterior soft tissue repair improves hip stability in THA performed via a posterior approach. Trans-osseous repair provides significantly greater resistance to dislocation torque than direct suturing and may be the preferred technique to reduce postoperative instability.
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