We performed a prospective clinical study in order to assess the effectiveness of repair of the short hip rotators, divided in the course of total hip replacement by the posterior approach, by the use of radio-opaque markers.

Fifteen patients, each with a diagnosis of osteoarthritis of the hip, were selected consecutively from a single surgeon’s operating list. Uncemented Duraloc® acetabular components and custom made cemented femoral components were implanted via the posterior approach in all patients.

Following implantation, the capsule and the short rotator tendons were sutured on to tendinous soft tissue around the greater trochanter using No 1 Vicryl. One radio-opaque marker clip was attached to the short rotators and capsule and a second marker was attached to the greater trochanter.

Standard antero-posterior pelvic X-rays were taken at three to five days post-operatively, and at three months following surgery. Significant separation of the radio-opaque markers in fourteen of the fifteen patients was demonstrated on the day three to five X-ray, indicating failure of the repair.

We conclude that this soft tissue repair is unsatisfactory. It may be of value to develop a more effective repair technique, with the overall aim of reducing total hip replacement dislocation, and as such we are currently investigating a soft tissue to bone repair.