A Clinical Comparative Study of the Direct Anterior With Mini-Posterior Approach: Two Consecutive Series

Abstract

We classified 182 consecutive patients (195 hips) treated by primary cementless minimally invasive total hip arthroplasty (MIS-THA) into 2 groups via the surgical approaches: direct anterior approach (DAA, 99 hips) and a mini-posterior approach (MPA, 96 hips). Ninety-nine percent of the cups in the DAA group and 91% in the MPA group had been implanted within the safe zone ( P = .008). Patients in the DAA group could get single-leg stance of more than 5 seconds by 16.6 days ( P = .0004), had positive Tredelenburg's sign by 29%, got 50-m walking time of 52.3 seconds ( P = .017), and showed improvement in the use of assistive walking aids ( P = .031) at 3 weeks postoperatively. The results of this study suggest more rapid recovery for hip function and gait ability after MIS-THA via a DAA when compared to an MPA.