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 use muscular 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 preferences was performed in 20 patients who had a two-incision THA in one hip and a modified Watson-Jones THA in the other between January 2004 and August 2007. The 20 patients were randomized equally to the two-incision first or the modified Watson-Jones first group. After the second surgery, patients were asked about their preferences for one of the two techniques and clinical results 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 results between techniques. However more patients (70%) preferred the two-incision side to the modified Watson-Jones side in the first 6 months regardless which procedure was performed first.

Conclusion: Given the similarity of these two techniques in cup implantation and with only a difference in femoral stem implantation, we think that the difference in patient preferences in the early postoperative period might be related to the surgical dissection and manipulation of the hip with the modified Watson-Jones technique.