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Clinical Orthopaedics and Related Research®

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01-02-2014 | Symposium: 2013 Hip Society Proceedings

Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?

Authors: José A. Rodriguez, MD, Ajit J. Deshmukh, MD, Parthiv A. Rathod, MD, Michelle L. Greiz, PT, Prashant P. Deshmane, MD, Matthew S. Hepinstall, MD, Amar S. Ranawat, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2014

Abstract

Background

Newer surgical approaches to THA, such as the direct anterior approach, may influence a patient’s time to recovery, but it is important to make sure that these approaches do not compromise reconstructive safety or accuracy.

Questions/purposes

We compared the direct anterior approach and conventional posterior approach in terms of (1) recovery of hip function after primary THA, (2) general health outcomes, (3) operative time and surgical complications, and (4) accuracy of component placement.

Methods

In this prospective, comparative, nonrandomized study of 120 patients (60 direct anterior THA, 60 posterior THAs), we assessed functional recovery using the VAS pain score, timed up and go (TUG) test, motor component of the Functional Independence Measure™ (M-FIM™), UCLA activity score, Harris hip score, and patient-maintained subjective milestone diary and general health outcome using SF-12 scores. Operative time, complications, and component placement were also compared.

Results

Functional recovery was faster in patients with the direct anterior approach on the basis of TUG and M-FIM™ up to 2 weeks; no differences were found in terms of the other metrics we used, and no differences were observed between groups beyond 6 weeks. General health outcomes, operative time, and complications were similar between groups. No clinically important differences were observed in terms of implant alignment.

Conclusions

We observed very modest functional advantages early in recovery after direct anterior THA compared to posterior-approach THA. Randomized trials are needed to validate these findings, and these findings may not generalize well to lower-volume practice settings or to surgeons earlier in the learning curve of direct anterior THA.

Level of Evidence

Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Title: Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?
Authors: José A. Rodriguez, MD
Ajit J. Deshmukh, MD
Parthiv A. Rathod, MD
Michelle L. Greiz, PT
Prashant P. Deshmane, MD
Matthew S. Hepinstall, MD
Amar S. Ranawat, MD
Publication date: 01-02-2014
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 2/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-3231-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does the Direct Anterior Approach in THA Offer Faster Rehabilitation and Comparable Safety to the Posterior Approach?

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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