J Korean Orthop Assoc.  2025 Mar;60(1):22-29. 10.4055/jkoa.2025.60.1.22.

Patient-Reported Outcome Measures of Staged Direct Anterior Approach and Direct Lateral Approach for Total Hip Arthroplasty Performed on the Same Patient

• Choi BY
• Chung WC
• Kim SJ
• Choi EH

• KMID: 2565926
• DOI: http://doi.org/10.4055/jkoa.2025.60.1.22

Abstract

Purpose
Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches. The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach.
Materials and Methods
This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis. Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated.
Results
Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference.
Conclusion
In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches. Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

Keyword

total hip arthroplasty; direct anterior approach; lateral approach