Abstract
Introduction: When the postoperative outcome of primary total hip arthroplasty (THA) was compared with the direct anterior approach (DAA) and the posterior approach (PA), there was no significant difference of the clinical outcome at 6 months to 1 year after surgery in many studies. This study was performed to compare the medium-term outcome of THA via the DAA or PA and clarify which approach achieves better quality of life (QOL).Methods: We investigated 61 hips receiving primary THA (30 via DAA and 31 via PA), using hip function scores such as the Harris Hip Score (HHS) and patient-reported outcomes such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and the Forgotten Joint Score-12 (FJS).Results: The mean duration of postoperative follow-up was 36.8 months in the DAA group and 40.5 months in the PA group. There was no difference in preoperative or postoperative HHS between the two groups. Although there was no difference of postoperative WOMAC and JHEQ, the postoperative FJS-12 score was significantly higher in the DAA group than in the PA group (75.2 ± 15.9 versus 60.1 ± 24.4, p = 0.01).Conclusion: When forgetting the artificial joint in daily life is the target, better QOL can be achieved by performing THA via the DAA.
Highlights
Total hip arthroplasty (THA) is an effective surgical procedure that leads to pain relief and functional recovery of the hip joint with improvement in the quality of life (QOL) [1]
Many authors have reported that differences in the clinical outcome of primary THA via the posterior approach (PA) or direct anterior approach (DAA) were undetectable by 6–12 months after surgery [10,11]
The present study followed patients for 3 years after surgery and revealed that the Forgotten Joint Score-12 (FJS)-12 score was significantly higher in DAA group than in the PA group
Summary
Total hip arthroplasty (THA) is an effective surgical procedure that leads to pain relief and functional recovery of the hip joint with improvement in the quality of life (QOL) [1]. The posterior approach (PA) is most widely employed for THA, since it provides adequate visualization of the hip joint and surrounding soft tissues, along with superior versatility and operability [2]. The direct anterior approach (DAA) has recently been attracting attention as the only approach employing an intermuscular and internervous plane [3]. It has advantages for pain relief and functional recovery early after surgery [4,5]. There have been reports that the PA is associated with a slightly higher dislocation rate
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