Two-incision versus Modified Watson-Jones Total Hip Arthroplasty in the Same Patients-- A Prospective Study of Clinical Outcomes and Patient Preferences

Background: The two-incision technique and the modified Watson-Jones technique usemuscular intervals and avoid muscle cutting in total hip arthroplasty (THA).However these two techniques have not been compared.Methods: A prospective randomized study of clinical outcomes and patient preferenceswas performed in 20 patients who had a two-incision THA in one hip and amodified Watson-Jones THA in the other between January 2004 and August2007. The 20 patients were randomized equally to the two-incision first orthe modified Watson-Jones first group. After the second surgery, patientswere asked about their preferences for one of the two techniques and clinicalresults were analyzed.Results: After a minimal follow-up of 2 years, there were no differences in the hospital course, clinical results, functional outcomes, and radiographic resultsbetween techniques. However more patients (70%) preferred the two-incision side to the modified Watson-Jones side in the first 6 months regardlesswhich procedure was performed first.Conclusion: Given the similarity of these two techniques in cup implantation and withonly a difference in femoral stem implantation, we think that the differencein patient preferences in the early postoperative period might be related tothe surgical dissection and manipulation of the hip with the modifiedWatson-Jones technique.