Abstract
Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) has rapidly become popular, but there is little consensus regarding the risks and benefits of this approach in comparison with a modern posterior approach (PA).
Methods: 2,147 patients who underwent DAA THA were propensity score matched with patients undergoing PA THA on the basis of age, gender, body-mass index (BMI) and American Society of Anaesthesia classification using data from a state joint replacement registry. Mean age of the matched cohort was 64.8 years, mean BMI was 29.1 kg/m2 and 53% were female. Multilevel logistic regression models using generalised estimating equations (GEEs) to control for grouping at the hospital level were utilised to identify differences in various outcomes.
Results: There was no difference in the dislocation rate between patients undergoing DAA (0.84%) and PA (0.79%) THA. Trends indicating a slightly longer length of stay with the PA and a slightly greater risk of fracture, increased blood loss and hematoma with the DAA are consistent with previous studies.
Conclusion: On the basis of short-term outcome and complication data, neither approach has a compelling advantage over each other, including no difference in the dislocation risk.
