Preserving the medial arm of the iliofemoral ligament in total hip arthroplasty using the anterolateral approach: A retrospective analysis of patient-reported outcome measure with 2 years follow-up

Purpose: Iliofemoral ligament (ILFL) is a capsular ligament located in the anterosuperior part of the hip joint capsule and contributes to hip joint stability. The purpose of this study was to compare the postoperative outcomes of resecting and preserving the medial arm of the ILFL in primary total hip arthroplasty (THA) using the anterolateral approach. Methods Patients with unilateral hip joint disease were selected, including 26 in the resection group and 23 in the preservation group. As a patient-reported outcome measure (PROM), the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire was administered at 3 months, 6 months, 1 year and 2 years postoperatively. Results The visual analog scale of satisfaction about the hip was significantly higher in the preservation group than in the resection group at 3 months (93.9 vs 80.8, P = 0.005), 6 months (94.3 vs 80.3, P = 0.001), and 1 year (94.0 vs 82.1, P = 0.001) postoperatively. The pain score of PROM was significantly superior in the preservation group than in the resection group at 3 months (25.2 vs 22.2, P = 0.024), 6 months (25.9 vs 21.8, P < 0.001), and 1 year (25.3 vs 21.8, P = 0.004) postoperatively. The mental score of PROM was significantly superior in the preservation group than in the resection group at 3 months (21.1 vs 17.7, P = 0.032), 6 months (23.3 vs 20.7, P = 0.038), and 1 year (23.3 vs 20.5, P = 0.027) postoperatively. Conclusion Our results demonstrated the effectiveness of preserving the medial arm of the ILFL in THA using the anterolateral approach for improvement of PROMs for 1 year postoperatively.