Prospective, Randomized Study of Direct Anterior Approach vs Posterolateral Approach Total Hip Arthroplasty: A...

Area of Science:

• Orthopedic surgery
• Hip arthroplasty outcomes

Background:

• Direct anterior approach (DAA) for hip surgery has gained popularity.
• Previous 12-month follow-up showed early functional and pain benefits for DAA over posterolateral approach (PA), with no long-term differences.
• This study extends follow-up to an average of 5 years.

Purpose of the Study:

• To compare the long-term (5-year) clinical and radiographic outcomes of direct anterior approach (DAA) versus posterolateral approach (PA) hip arthroplasty.
• To evaluate survivorship, functional scores, and implant integrity between the two surgical approaches.

Main Methods:

• Prospective study comparing 43 DAA patients and 44 PA patients from an original cohort.
• Clinical evaluation using Harris hip score, UCLA activity score, and Hip Disability and Osteoarthritis Outcome Score Jr.
• Survivorship analysis and radiographic assessment for loosening and radiolucent lines at average 5-year follow-up.

Main Results:

• No statistically significant differences were observed between DAA and PA in Harris hip score, UCLA activity score, or HODOS Jr.
• Survivorship at 7 years was not significantly different between the two groups.
• No implant loosening or radiolucent lines were detected at the 5-year follow-up.

Conclusions:

• Both direct anterior approach (DAA) and posterolateral approach (PA) demonstrate comparable efficacy in hip arthroplasty at 5-year follow-up.
• Long-term functional outcomes, survivorship, and radiographic results are similar for both surgical techniques.
• The study supports the use of either DAA or PA based on surgeon preference and patient factors.