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A systematic review was conducted to answer the question, “Does the surgical approach influence the blood flow to the femoral head?”. All articles published from January 1990 to September 2014 were included. Multiple databases were used for the search. Search criteria revealed 19 articles initially and 11 articles for the final analysis (Figure 1). These were further analysed using a data extraction form (Figure 2). Each article was critically appraised. No randomised control trial (RCT) was found in the search and the remaining studies did not clearly show a significant reduction in blood flow during a posterior approach that can be directly linked to the development of avascular necrosis.

Blood flow to the femoral head during different surgical approaches to the hip: a systematic review of literature