International Orthopaedics

, Volume 42, Issue 12, pp 2771–2775 | Cite as

Patient’s perspective on direct anterior versus posterior approach total hip arthroplasty

  • Dragan RadoicicEmail author
  • Vladimir Zec
  • Walaa Ikram Elassuity
  • Mostafa Abdelmaboud Azab
Original Paper



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.


Direct 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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Orthopedic Surgery and Traumatology ClinicMilitary Medical AcademyBelgradeSerbia
  2. 2.Exeter Bone&JointAbu DhabiUnited Arab Emirates
  3. 3.Exeter Bone&JointDubaiUnited Arab Emirates

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