Length of Hospital Stay between Direct Anterior Approach and Posterior Approach in Primary Total Hip Arthroplasty

The surgical approach used in performance of total hip arthroplasty (THA) is critical in determining the postoperative recovery process. The direct anterior approach (DAA) is a minimally invasive technique that preserves soft tissue, while the posterior approach (PA) is a traditional method providing a more extensive view of the hip joint. Length of stay (LOS) is an essential metric in assessing healthcare efficiency and patient recovery. The aim of this article is to compare LOS in patients undergoing THA via the DAA versus the PA.

A retrospective matched pair analysis of THA patients undergoing either DAA or PA was conducted. Collected data from the hospital records focused on LOS and perioperative complications. Statistical analysis was performed to determine the significance of differences in LOS between the two approaches.

Each group included 69 patients. The results of the analysis revealed that there was no difference in LOS between patients who underwent DAA as compared to those who underwent PA (P=0.16). No difference in perioperative complications was observed between the two the groups in terms of surgical duration (P=0.09) and blood loss (P=0.22).

Based on the results, we conclude that the DAA did not result in lower LOS compared with the conventional PA. This study also highlights the impact of hospital protocols, ERAS^® (Enhanced Recovery After Surgery) programs, and patient factors on LOS beyond the surgical approach alone. Further research including randomized controlled studies, evolving surgical technologies, personalized care and long term follow up is warranted.