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Acetabular and Femoral Component Positioning Using Direct Anterior Approach Versus Posterior Approach in Total Hip Arthroplasty

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Abstract

Purpose

Direct anterior approach (DAA) has recently become popular in total hip arthroplasty (THA). However, irrespective of the surgical approach used, component malposition is an important factor affecting function and complications after THA. This study aims to compare component positioning on the femoral and acetabular side between DAA and posterior approach (PA) to the hip joint. We hypothesized that the two approaches are similar in terms of component positioning.

Methods

We prospectively studied 50 patients, matched according to age, sex, and body mass index, undergoing THA, divided non-randomly into 2 groups. Group 1 comprised 25 patients (35 hips) undergoing THA using DAA and group 2 comprised 25 patients (25 hips) undergoing THA using PA. Ten patients from group 1 had simultaneous bilateral THA. Radiological parameters studied were acetabular inclination (AI), coronal femoral stem alignment (CFA), leg length difference (LLD), acetabular cup version (AV), and femoral stem version (FV).

Results

There was no significant difference in AI, CFA, LLD, AV, and FV between the two groups. Excellent to good inter and intra-observer reliability expressed in terms of intraclass correlation coefficient (ICC) was noted for all the radiographic measurements.

Conclusion

Both DAA and PA for THA achieve comparable radiological component positioning. DAA may not provide any advantage over PA in terms of positioning of the prosthesis.

Level of Evidence

Level II, non-randomized comparative study.

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, 151001, Punjab, India

    Tarun Goyal

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

    Arghya Kundu Choudhury, Souvik Paul, Tushar Gupta & Lakshmana Das

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  1. Tarun Goyal
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  2. Arghya Kundu Choudhury
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  3. Souvik Paul
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Correspondence to Tarun Goyal.

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The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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The institutional ethics committee approved the study. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The study was conducted in All India Institute of Medical Sciences, Rishikesh, India.

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Goyal, T., Choudhury, A.K., Paul, S. et al. Acetabular and Femoral Component Positioning Using Direct Anterior Approach Versus Posterior Approach in Total Hip Arthroplasty. JOIO 55, 1215–1224 (2021). https://doi.org/10.1007/s43465-020-00343-9

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  • DOI: https://doi.org/10.1007/s43465-020-00343-9

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