Abstract
A telephone questionnaire was utilized to assess whether patients who underwent staged bilateral total hip replacement using the direct anterior approach for one hip replacement, and a different surgical approach for the other, could detect a difference in their post-operative recovery. When comparing patients who preferred the results of one hip replacement over another, the DAA was associated with more patient satisfaction, a quicker recovery, less pain, better function, and better fulfillment of pre-operative expectations, while there was no difference in hip strength between groups. These results suggest randomized controlled trials are worth pursuing to determine if a clinically meaningful difference exists between the direct anterior approach and other surgical approaches.
Highlights
The direct anterior approach (DAA) for total hip arthroplasty has gained recent interest following the reported claims of a quicker recovery [1,2,3], minimal post-operative pain [4], and a low dislocation rate without hip precautions [5,6] compared to other surgical approaches
The clinical database of the senior author was searched for patients with bilateral total hip arthroplasty who had one hip replaced with the direct anterior approach and the other with a different approach
When comparing patients who preferred the results of one hip replacement over another, the DAA was associated with a quicker recovery (P
Summary
The direct anterior approach (DAA) for total hip arthroplasty has gained recent interest following the reported claims of a quicker recovery [1,2,3], minimal post-operative pain [4], and a low dislocation rate without hip precautions [5,6] compared to other surgical approaches. These outcome measures are mostly attributed to the internervous plane of the direct anterior approach that does not require splitting muscle to achieve exposure of the hip joint [7]. We hypothesized that patients would perceive no difference between the direct anterior approach and alternative surgical exposures for total hip arthroplasty with respect to the post-operative duration of recovery, pain, or more closely meet pre-operative expectations
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