Related Experiment Video
Updated: Apr 16, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty
Johannes C Reichert1, Maximilian R Volkmann2, Maximilian Koppmair2
1Department of Orthopaedic and Trauma Surgery, Ev. Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589, Berlin, Germany.
Purpose:
The presented retrospective study compares clinical outcomes five years after total hip arthroplasty performed through a minimally invasive direct anterior approach and a direct transgluteal lateral approach.
Methods:
A total of 171 arthroplasties in 167 patients were evaluated utilizing the Harris hip score (HHS), the SF-36, a daily activity questionnaire, and the UCLA activity score.
Results:
The average HHS showed no significant difference equalling 91.4 points in the anterior group and 92.4 in the lateral group (p = 0.952). The SF-36 physical component scores were 50.7 (anterior) and 50.0 (lateral) while the psychometric properties added up to 48.6 (anterior) and 50.3 (lateral) with no significant differences evident (p = 0.782, p = 0.071). Daily activity was found to result in 4,855 (anterior) and 5,016 (lateral) cycles, respectively (p = 0.364). No difference regarding pain sensation was determined (p = 0.859). A significant difference was found for the UCLA score, which was calculated to be 5.9 in the anterior and 6.4 in the lateral approach group (p = 0.008).
Conclusion:
In summary, our mid-term results show comparable outcomes for both approaches regarding functionality, pain, quality of life and daily activity.
