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Direct anterior approach versus posterolateral approach in total hip arthroplasty : one surgeon, two approaches.
Acta Orthopaedica Belgica 2016 August
Early research shows several advantages of the Direct Anterior Approach (DAA) in total hip arthroplasty (THA), although no studies evaluated the DAA on a regular operating table without using fluoroscopy. We performed a retrospective cohort study on the outcome of this variation of the DAA compared with the posterolateral approach (PLA) with one year follow-up. All procedures were uncemented THA performed in 2012 by a single surgeon. Patients in the DAA group (N = 45) had a lower Body Mass Index (p > .001) than the PLA group (N = 38). Functional outcome, pain scores and complications were comparable between the two approaches. Compared with PLA, the DAA was associated with longer operation time (p > 0.001), more blood loss (p > 0.001), shorter length of stay (p = .009), and more adequate acetabular cup inclination (p = .004). This study shows that the DAA on a regular operating table without using fluoroscopy has several advantages compared to the PLA.
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