Evaluating the Clinical Outcomes and Biomechanical Advantages of the Piriformis Muscle-Sparing Posterior Approach in Total Hip Replacement: A Comparative Study
1Dr Muhammad Inam, 2Dr.Abdul Basit, 3Dr Muhammad Asim Munir Qureshi, 4Dr Ansa Batool, 5Dr Danish
Submission: 14 January 2026 | Acceptance: 15 February 2026 | Publication: 10 March 2026,
1FCPS FRCS Associate Professor of Orthopedics Medical Teaching Institute Lady Reading Hospital Peshawar Pakistan
2Consultant Orthopedic SurgeonGovt.Aziz Bibi THQ hospital Roshan Bheela Kasur
3Senior registrar lahore general hospital , Lahore
4PIMS
5NESCOM
ABSTRACT:
Background: The posterior approach in total hip replacement (THR) is widely used; however, concerns about postoperative stability and muscle damage remain. The piriformis muscle-sparing technique has been proposed to preserve biomechanical function and reduce complications.
Aim: This study aimed to evaluate the clinical outcomes and biomechanical advantages of the piriformis muscle-sparing posterior approach in THR compared to the conventional posterior approach.
Methods: A comparative study was conducted at Services Hospital, Lahore, from October 2023 to September 2024. A total of 50 patients undergoing THR were included and divided into two groups: the piriformis-sparing approach (n=25) and the conventional posterior approach (n=25). Clinical outcomes were assessed using the Harris Hip Score (HHS) and postoperative pain levels. Biomechanical advantages, including gait analysis and hip stability, were also evaluated.
Results: Patients in the piriformis-sparing group demonstrated significantly higher HHS scores at three and six months postoperatively (p<0.05). Pain levels were lower in this group compared to the conventional approach. Gait analysis revealed improved hip stability, with a lower incidence of postoperative limp and dislocations. The preservation of the piriformis muscle contributed to enhanced early mobility and faster recovery.
Conclusion: The piriformis muscle-sparing posterior approach in THR resulted in superior clinical outcomes and biomechanical advantages compared to the conventional approach. This technique enhanced early functional recovery, reduced postoperative complications, and improved overall hip stability. Further research with larger sample sizes is recommended to validate these findings.
Keywords: Total hip replacement, piriformis muscle-sparing, posterior approach, hip stability, clinical outcomes, biomechanics, functional recovery.