Anterior approach to total hip replacement versus direct lateral approach

Anterior approach to total hip replacement versus direct lateral approach

In the August 2010 Journal of Arthroplasty, a study out of the Rothman Clinic compared use of an anterior approach to total hip replacement to that using a direct lateral approach. This was a prospective randomized clinical trial indicating that patients could not choose which approach they received; rather they were randomized based on a computer program. This is the highest level of significance in clinical studies used in medicine. The study showed that many things were similar; however, there was a statistically significant difference with regard to speed of recovery, early improvement in function and better patient satisfaction during the first several months postoperatively using an anterior approach. At two years there was no difference between the surgical approaches with regard to patient function or satisfaction.

We are currently enrolling patients in a prospective randomized clinical study comparing anterior approach total hip to posterior approach total hip. All parameters are identical with the exception of the surgical approach. We are approximately half way through the enrollment process and anticipate finishing this in early 2011.

We will report our results after all of the patients have reached a minimum one-year followup. We feel we owe it to our patients and the medical community to test the validity of one surgical approach over another by use of a prospectively randomized clinical trial. Stay tuned for more information.

— William P. Barrett, MD

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