Is there faster recovery with an anterior or anterolateral THA? A pilot study

Surgical technique is an important factor affecting recovery of hip function after total hip arthroplasty (THA). We therefore asked whether short-term recovery of hip strength and motion would differ between the anterior and anterolateral THA approaches. We presumed that although both approaches would improve hip function by 16 weeks postsurgery when compared with presurgery, a slower recovery would be demonstrated by the anterolateral group at 6 weeks when compared with the anterior group as a result of division and reattachment of the abductor muscles. We observed hip kinematics and kinetics during walking and isometric hip abductor strength for the involved limb. Hip abductor strength of all patients was lower than controls at all three testing times. Compared with presurgery, all patients demonstrated improved abductor strength at 16 weeks postsurgery. At 6 weeks, the patients with an anterior approach had improved late stance peak abductor moment postsurgery and reached the level of controls, but those with an anterolateral approach did not. Although the anterior approach was associated with improved gait velocity and peak flexor moments at 6 weeks compared to before surgery, we observed no differences between the two approaches for most of the isometric strength and dynamic gait measures at 6 or 16 weeks. Neither approach provided faster recovery.