Patient’s perspective on direct anterior versus posterior approach total hip arthroplasty
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Total hip arthroplasty approach comparison focused on patient’s perspective. The direct anterior approach (DAA) has gained immense popularity in the last decade and is widely advocated as a superior approach in terms of quicker recovery and better overall outcome. However, the question if the level of DAA promotion is justified seems to be rarely posed.
A single-surgeon consecutive series of patients who underwent bilateral THA, one in DAA and the other in posterior approach (PA). The same implant design and same component sizes were used for the both sides. All the operations were performed by a single surgeon under the same pre- and post-operative care protocol.
Twenty-one patients underwent bilateral THA, mean age 60.09 years. Oxford Hip Score (OHS) was used for functional outcome assessment. There were no statistically significant differences between two approaches in terms of functional outcome (mean OHS for DAA series was 42.95 and that for the PA was 43.38, p 0.07 at an alpha level of 0.05). Fifteen patients gave the advantage to PA, and six patients favoured DAA.
By study design, we tried to reduce the biases and acquire approach appraisal from patient’s perspective. We anticipated the outcome in favour of DAA, but the results favoring PA came as a surprise. Future prospective randomized studies on evaluation of DAA and other approaches not only from surgeon’s or industry’s point of view, performed on a larger and more uniform groups, are warranted to further explore the subjective differences between DAA and PA.
KeywordsDirect anterior approach Patient’s perspective Total hip arthroplasty approach
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Institutional review board approval was obtained prior to starting this research.
All procedures performed in this study were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Poehling-Monaghan KL, Kamath AF, Taunton MJ, Pagnano MW (2015) Direct anterior versus miniposterior THA with the same advanced perioperative protocols: surprising early clinical results. Clin Orthop Relat Res 473(2):623–631Google Scholar
- 2.Schwartz BE, Sisko ZW, Mayekar EM, Wang OJ, Gordon AC (2016) Transitioning to the direct anterior approach in total hip arthroplasty: is it safe in the current health care climate? J Arthroplast 31(12):2819–2824Google Scholar
- 3.Nistor DV, Caterev S, Bolboacă SD, Cosma D, Lucaciu DOG, Todor A (2017) Transitioning to the direct anterior approach in total hip arthroplasty. Is it a true muscle sparing approach when performed by a low volume hip replacement surgeon? Int Orthop 41:2245. https://doi.org/10.1007/s00264-017-3480-8
- 4.Post ZD, Orozco F, Diaz-Ledezma C, Hozack WJ, Ong A (2014) Direct anterior approach for total hip arthroplasty: indications, technique, and results. J Am Acad Orthop Surg 22(9):595–603Google Scholar
- 16.Field RE, Cronin MD, Singh PJ (2005) The Oxford Hip Scores for primary and revision hip replacement. Bone Joint Journal 87(5):618–622Google Scholar
- 24.Nilsdotter A, Bremander A (2011) Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire. Arthritis Care Res 63(S11)Google Scholar