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Published on: September 7, 2022
Comparing Direct Anterior Approach Versus Posterolateral Approach in Total Hip Arthroplasty on Physical Function
Jesse C Christensen1, Dana L Judd2, Jeri E Forster3
1Veterans Affairs Salt Lake City Health Care System, Department of Physical Medicine and Rehabilitation, Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, USA.
The direct anterior approach (DAA) for total hip arthroplasty (THA) showed improved physical function recovery, including better walking distance and hip strength, compared to the posterolateral approach (PLA). Both approaches demonstrated success in patient recovery post-surgery.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Rehabilitation Science
Background:
- Total hip arthroplasty (THA) is a common procedure with significant impact on patient physical function.
- Post-THA recovery can be hindered by muscle weakness and altered joint mechanics.
- The surgical approach, such as direct anterior approach (DAA) versus posterolateral approach (PLA), may influence recovery outcomes.
Purpose of the Study:
- To compare the physical function recovery between DAA and PLA in patients undergoing primary unilateral THA.
- To evaluate differences in gait, muscle strength, and joint mechanics over 24 weeks post-surgery.
Main Methods:
- A prospective study involving 93 participants undergoing THA (68 DAA, 25 PLA).
- Assessment of physical function, including 6-min walk test, gait, step count, muscle strength, and joint mechanics, at pre-op, 10, and 24 weeks post-op.
- Statistical analysis using repeated measures ANCOVA, adjusting for relevant covariates.
Main Results:
- DAA group showed greater 6-min walk distance at 24 weeks and improved hip abductor strength at 10 weeks compared to PLA.
- Subtle reductions in hip and trunk mechanics were observed in the DAA group during walking and step negotiation.
- Both surgical approaches led to successful patient recovery.
Conclusions:
- The DAA demonstrated marginal improvements in specific physical recovery metrics (walking distance, hip strength, joint mechanics) compared to PLA.
- These findings suggest DAA may offer advantages in early physical function recovery after THA.
- Both DAA and PLA are successful surgical options for THA, with potential nuances in recovery trajectories.
