Anterior versus posterior approach total hip arthroplasty: patient-reported and functional outcomes in the early postoperative period.
Hip international : the journal of clinical and experimental research on hip pathology and therapy
PURPOSE: Direct anterior approach total hip arthroplasty (DA THA) has been reported to improve early outcomes compared to posterior approach THA up to 6 weeks postoperatively. Limited weekly outcomes data are available prior to 6 weeks. We evaluate outcomes including when patients first drive a car, leave home, and discontinue their assist device.
METHODS: Patients undergoing THA for primary osteoarthritis were prospectively enrolled. Outcomes data were collected preoperatively and postoperatively at weekly intervals for 6 weeks.
RESULTS: 111 patients (55 DA and 56 posterior approach) were enrolled. There was no significant difference (
CONCLUSIONS: Patients undergoing DA THA discontinued their assistive device, left their home, and drove a car sooner than posterior approach patients. We found improvement in physical function with DA, and it persisted up to 5 weeks postoperatively. Furthermore, DA patients had significantly shorter length of stay, improved mobilisation, decreased narcotic requirements and improved inpatient pain scores compared to posterior approach THA. Future randomised controlled study should be performed to minimise the biases inherent in this study methodology and confirm the results.
Martusiewicz A, Delagrammaticas D, Harold RE, Bhatt S, Beal MD, Manning DW. Anterior versus posterior approach total hip arthroplasty: patient-reported and functional outcomes in the early postoperative period. Hip Int. 2020 Nov;30(6):695-702. doi: 10.1177/1120700019881413. Epub 2019 Oct 6. PMID: 31588801.