Comparison of functional and patient-reported outcomes between direct anterior and lateral surgical approach one-year after total hip arthroplasty in a Canadian population: A cross-sectional study.

Authors

Susan W. Hunter, Western UniversityFollow
Pavlos Bobos
Lyndsay Somerville
James Howard
Edward Vasarhelyi
Brent Lanting

Document Type

Article

Publication Date

11-13-2019

Journal

Journal of Orthopaedics

Volume

19

Issue

11

First Page

36

Last Page

40

URL with Digital Object Identifier

https://doi.org10.1016/j.jor.2019.11.004

Abstract

Background: From a clinical perspective, it is important to understand the outcomes that occur after total hip arthroplasty (THA) and do these vary with surgical approach. The objective of the study was to compare physical performance-based and patient-report outcomes between the Direct Anterior (DA) and Direct Lateral (DL) surgical approach at one-year after THA surgery.

Methods: We evaluated patients attending their one-year follow-up assessment after primary elective unilateral THA surgery for osteoarthritis of the hip. The Activities-specific Balance Confidence Scale, Falls Risk in Older People in a Community Setting, Timed Up and Go Test, 30-Second Chair Stand Test, Step Test, 6-Meter Walk Test, Harris Hip Score (HHS), Short-form 12 and the Western Ontario and McMaster Osteoarthritis Index (WOMAC) were assessed. The standardized mean difference (SMD) and 95% confidence intervals (CI) was calculated to evaluate the statistical difference between groups and the magnitude of the effects.

Results: In total, 135 individuals met the inclusion criteria and participated in the study. A statistically significant and clinically important difference in favor of the DA was found for the WOMAC (0.60, 95% CI (0.25, 0.95), p = .004), SF-12 Physical component (0.42, 95% CI (0.07, 0.76), p = .01) and 6-Meter Walk Test (0.52, 95% CI (-0.86, -0.17), p = .009). Small effect sizes, though not statistically significant differences, were found in favor of the DA approach for the other patient-report and physical performance-based measures.

Conclusion: The WOMAC, gait speed and SF-12 Physical component scores were significantly different in favor of the DA procedure at one-year after THA. However, only the WOMAC scores exceeded a clinically important threshold in favor of DA approach. The other self-report and physical performance measures were not significantly different between the two procedures at one-year postoperatively.

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