Evidence brief
A Randomized Controlled Trial of Direct Anterior versus Posterior Approach for Total Hip Arthroplasty
DAA associated with shorter hospital stay and faster early recovery
No significant difference in long-term outcomes at 1 year
DAA learning curve is significant (40-100 cases)
Posterior approach has higher dislocation rate without repair
Both approaches can achieve excellent outcomes with proper technique
Approach selection should be based on surgeon experience and patient factors. The DAA offers faster early recovery but has a significant learning curve and complication profile. Posterior approach with capsule repair has low dislocation rates.
Know the pros/cons of each approach. DAA: faster recovery, muscle-sparing, but learning curve, LFCN injury, femoral fracture risk. Posterior: versatile, easier exposure, but higher dislocation without capsule repair. Surgeon experience is key factor.
Barrett WP et al. Prospective randomized study of direct anterior vs posterolateral approach for total hip arthroplasty. J Arthroplasty. 2013;28(9):1634-1638.
Level I
Systematic review of RCTs or high-quality RCT