# Transgluteal vs. Anterior and Posterior Approaches for Porcine Model of Irreparable Acetabular Labral Tear: A Comparative Study on Feasibility and Safety

## TL;DR

This study compares three surgical approaches for creating a porcine model of irreparable hip labral tears, finding that the transgluteal method is safer and more effective.

## Contribution

The study introduces a comparative analysis of three surgical approaches for a porcine model of acetabular labral tears, focusing on feasibility and safety.

## Key findings

- The anterior approach caused more blood loss and longer operative times compared to posterior and transgluteal approaches.
- The transgluteal approach showed better survival rates and fewer complications compared to the anterior approach.
- Postoperative complications included sciatic nerve issues, chondral lesions, and poor wound healing across the groups.

## Abstract

To compare the surgical feasibility and safety of three approaches (anterior, transgluteal, posterior) for constructing a porcine model of irreparable acetabular labral tear.

After a cadaveric anatomical exploration in two pigs to define feasible corridors, 36 male Chinese miniature pigs were randomized (1:1:1) to anterior, transgluteal, or posterior approaches for model construction and labral reconstruction. Primary intraoperative outcomes were blood loss, operative time, and a 0–10 surgical exposure score; postoperative complications and survival were assessed over 3 months.

The anterior approach showed greater blood loss and longer operative time than posterior and transgluteal (both p < 0.001), while exposure was worst with anterior (p < 0.001) and only trended better with transgluteal versus posterior (p = 0.056). Postoperative events included sciatic nerve‐related claudication (4/12 posterior), acetabular chondral lesions (3/12 anterior), and poor wound healing (4/12 anterior; 2/12 posterior). One‐month survival was lower in anterior versus transgluteal (p = 0.025), with most deaths within 2 weeks; 2‐ and 3‐month survival were also lower for anterior versus transgluteal (p = 0.026; p = 0.011). At 2 months, survival was lower in anterior versus posterior (p = 0.011).

The transgluteal approach appears to be a relatively safe and effective option for constructing porcine hip models; nevertheless, conclusions should be interpreted with caution given the undetermined mortality etiology in the anterior group.