Comparative retrospective study of the direct anterior and transgluteal approaches for primary total hip arthroplasty

Int Orthop. 2015 Dec;39(12):2309-13. doi: 10.1007/s00264-015-2732-8. Epub 2015 Mar 21.

Abstract

Purpose: The presented retrospective study compares clinical outcomes five years after total hip arthroplasty performed through a minimally invasive direct anterior approach and a direct transgluteal lateral approach.

Methods: A total of 171 arthroplasties in 167 patients were evaluated utilizing the Harris hip score (HHS), the SF-36, a daily activity questionnaire, and the UCLA activity score.

Results: The average HHS showed no significant difference equalling 91.4 points in the anterior group and 92.4 in the lateral group (p = 0.952). The SF-36 physical component scores were 50.7 (anterior) and 50.0 (lateral) while the psychometric properties added up to 48.6 (anterior) and 50.3 (lateral) with no significant differences evident (p = 0.782, p = 0.071). Daily activity was found to result in 4,855 (anterior) and 5,016 (lateral) cycles, respectively (p = 0.364). No difference regarding pain sensation was determined (p = 0.859). A significant difference was found for the UCLA score, which was calculated to be 5.9 in the anterior and 6.4 in the lateral approach group (p = 0.008).

Conclusion: In summary, our mid-term results show comparable outcomes for both approaches regarding functionality, pain, quality of life and daily activity.

Keywords: Direct anterior approach; Mid-term; Outcome; Total hip arthroplasty; Transgluteal approach.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Osteoarthritis, Hip / surgery*
  • Retrospective Studies