Direct Anterior Approach in Total Hip Arthroplasty Leads to Superior Outcomes at 3-Month Follow-up When Compared With the Posterior Approach: A Matched Study Using Propensity Score Analysis

Direct Anterior Approach in Total Hip Arthroplasty Leads to Superior Outcomes at 3-Month Follow-up When Compared With the Posterior Approach: A Matched Study Using Propensity Score Analysis

Authors: Maldonado DR, Laseter JR, Kyin C, Lall AC, Domb BG

DOI: 10.5435/JAAOSGlobal-D-19-00118

Background

The direct anterior approach (DAA) for total hip arthroplasty (THA) is increasingly used, yet evidence comparing its short-term outcomes to the traditional posterior approach (PA) remains limited.

Methods

This propensity score-matched study compared early postoperative outcomes at 3 months in patients undergoing THA via DAA versus PA, measuring hip function (Harris Hip Score), quality of life (Veterans RAND-12), and patient satisfaction.

Key Findings

• Patients in the DAA cohort reported significantly improved hip function scores and quality of life metrics at 3 months.
• Patient satisfaction was higher with DAA compared to PA.

Conclusions

DAA offers superior early functional recovery and patient satisfaction relative to the posterior approach in total hip arthroplasty.

What Does This Mean for Providers?

Surgeons should consider the direct anterior approach for suitable THA candidates to potentially enhance early postoperative recovery and patient-reported outcomes. Mastery of the DAA technique and patient selection remain essential to optimize benefits and minimize complications.