Early outcomes of total hip arthroplasty procedures performed by using direct anterior approach

Purpose: The purpose of this study is to evaluate the clinical and radiological results of the patients who had been treated with total hip arthroplasty performed by a surgeon using direct anterior approach and to compare the obtained results with different surgical approaches in literature. Materials and Method: 37 patients and 42 hips were included in the study, which underwent total hip prosthesis by using direct anterior approach and had been followed-up regularly between 2015 and 2019 in Sakarya University Training and Research Hospital Orthopedics and Traumatology Clinic. Direct anterior approach was preferred in all cases. Harris hip scores were recorded pre-operatively and on the 6th month post-operatively. Relationship between gender, diagnosis, body mass index, walking time and acetabular inclination angle was researched by using the obtained scores. Findings: The cases include 26 women (70.3%), 11 men (29.8%) and ages are between 26 and 76. The average age is 51.2. The patients were followed-up for approximately 32 (8 – 52) months. Harris hip score is 48 on average pre-operatively and it is 95.4 post-operatively. No significant difference was seen between gender, age, BMI, post-operative acetabular inclination angle, the duration of hospitalization and the improvement in Harris hip score. Dislocation on early stage was seen in one of our patients and close reduction was performed. Infection was observed in one of our patients and prosthesis was removed and an antibiotic-loaded spacer was placed. Fissure was observed on the proximal of the femur intra-operatively in 3 of our patients and they were fixed by cable. Conclusion: Our study shows that successful and quick functional results are obtained with total hip prosthesis performed by using direct anterior approach along with suitable indication and surgical technic. When compared with literature, quicker recovery than other approaches are observed on early stages, yet no significant difference is observed between the approaches in the medium and long terms.