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Radiographic and Clinical Outcomes After Direct Anterior Versus Mini Posterior Total Hip Arthroplasty
David A Hamilton1, Colin A McNamara1,2, Austin E Wininger1
1Houston Methodist Hospital, Houston Methodist Orthopedics & Sports Medicine, Houston, TX.
Arthroplasty Today
|March 21, 2025
Summary
Direct anterior approach (DAA) and posterior approach (PA) for total hip arthroplasty (THA) show similar outcomes. DAA had no dislocations, while PA had one, but both approaches are effective for hip arthritis treatment.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Total hip arthroplasty (THA) is a common procedure for end-stage hip arthritis.
- Surgical approach controversy exists regarding implant outcomes and positioning.
- Direct anterior approach (DAA) and posterior approach (PA) are widely used THA techniques.
Purpose of the Study:
- To compare radiographic and clinical outcomes of primary THA.
- To evaluate differences between DAA and PA in implant positioning and complications.
- To assess surgeon-specific factors influencing THA outcomes.
Main Methods:
- Retrospective cohort study comparing 198 DAA patients with 198 PA patients.
- Analysis of radiographic parameters: cup anteversion, abduction, femoral alignment, offset, and leg-length discrepancy.
- Extraction and comparison of postoperative complications: infection, wound issues, fracture, and dislocation.
Main Results:
- No significant differences in overall postoperative complications between DAA and PA.
- DAA resulted in longer operative times (117 vs 79 minutes).
- PA showed greater increases in femoral offset and cup anteversion, with higher dual mobility component use.
Conclusions:
- Both DAA and PA yield acceptable clinical and radiographic outcomes for primary THA.
- Significant differences observed in cup positioning and femoral offset may relate to surgeon technique.
- These technique variations likely aim to minimize dislocation risk.
