Surgical management of proximal femoral benign lesions: Simple lateral femoral approach vs. Watson-Jones approach

Abstract Objective: To compare the simple lateral femoral approach and the Watson-Jones approach in the treatment of proximal femoral benign lesions. Methods: A retrospective analysis of the clinical data of 45 patients with proximal femoral benign lesions treated by the simple lateral femoral approach and the Watson-Jones approach January 2016 to January 2021 was performed to record all data by comparing incision length, surgical exposure time, intraoperative blood loss, treatment effect includes postoperative bed time, hospital stay, weight-bearing time, Musculoskeletal Tumor Society (MSTS) score, visual analog scale (VAS) score. Patients were routinely followed up at 1, 3, 6, 9 and 12 months postoperatively. The lower limb function and the complications were recorded. Results: There was a significant difference (mean±SD) in the length of surgical incision [9.1±1.6 vs. 15.7±1.7 cm] (P < 0.05), intraoperative blood loss [259.1±206.0 vs.1004.7±815.7 mL] (P < 0.05); postoperative weight-bearing time [45.8±28.8vs. 57.9±37.8 day] (P < 0.05) and VAS Score on the third postoperative day [2.1±0.7 vs. 3.3±0.7 day] (P < 0.05). There was one patient (4.5%) in the Watson-Jones approach group with postoperative wound fat liquefaction and superficial infection, then the wound completely improved by secretion culture, enhanced dressing and effective antibiotics. One patient (4.5%) in the Watson-Jones approach group experienced abduction weakness. Conclusion: These data suggest that the simple lateral femoral approach for lesion curettage and internal fixation, which is an effective and safe option for proximal femoral benign lesions. In some extent, it can be used as a modified alternative of the Watson-Jones approach despite the fact that it just has relative limited indications.