Direct anterior approach versus posterolateral approach in total hip arthroplasty : one surgeon, two approaches

Early research shows several advantages of the Direct Anterior Approach (DAA) in total hip arthroplasty (THA), although no studies evaluated the DAA on a regular operating table without using fluoroscopy. We performed a retrospective cohort study on the outcome of this variation of the DAA compared with the posterolateral approach (PLA) with one year follow-up. All procedures were uncemented THA performed in 2012 by a single surgeon. Patients in the DAA group (N = 45) had a lower Body Mass Index (p > .001) than the PLA group (N = 38). Functional outcome, pain scores and complications were comparable between the two approaches. Compared with PLA, the DAA was associated with longer operation time (p > 0.001), more blood loss (p > 0.001), shorter length of stay (p = .009), and more adequate acetabular cup inclination (p = .004). This study shows that the DAA on a regular operating table without using fluoroscopy has several advantages compared to the PLA.