Caveat Emptor

Every month, it seems that healthcare consumers hear about the “latest and greatest” drug, technology, or surgical technique that sounds too good to be true—and too compelling to pass up. Over the past year or 2, the direct anterior total hip approach has received a lot of attention on the Internet and in the media. Is it as good as it sounds?

Well, first, there are many ways to do a total hip replacement. The surgeon can make an incision in the back of the hip (posterior approach), the side of the hip (anterolateral or direct lateral approach), the front of the hip (anterior approach) or using a combination such as in the 2-incision approach. The anterior approach has recently been touted by many surgeons as being superior to other approaches because it “cuts no muscle,” implying that the other approaches must cut a lot of muscles.

So I decided to see if there was any data substantiating the superiority of the anterior approach over other approaches. Woolson, et al recently showed a significantly higher complication rate using the anterior approach (http://tinyurl.com/nt7hnm, http://tinyurl.com/m4fcjh), and Hungerford, et al showed a significant learning curve for the anterior approach (http://tinyurl.com/l6y67g) at this years American Academy of Orthopedic Surgeons meeting in Las Vegas, NV. Seng, et al published very similar results (http://tinyurl.com/ltvr58). Jarrett, et al found no advantages to the anterior approach and noted some distinct disadvantages (http://tinyurl.com/nua37g).

Although the proponents of the anterior approach are quick to point out the theoretical advantages of this approach, the facts do not support their claims, and in fact, some studies suggest that the approach may be inferior to others. So as with all media hype of new technologies, surgical techniques, and drugs, don’t buy into things that sound too good to be true. Many persons and companies profit from use of these products and will make unfounded statements to sell their product directly to consumers and to increase their profits. So when the next new technology is hyped in the media, remember, Caveat Emptor.