Comparison of Biomechanical, Clinical Indicators, and Quality of Life in People Undergoing Hip Replacement Surgery with Anterior and Posterior Approaches

Background: There are ongoing debates among surgeons regarding the most effective surgical method for hip replacement, with varying preferences for the anterior and posterior approaches. Both methods have demonstrated excellent long-term outcomes, with clinical differences primarily observed in the early postoperative period. Objectives: This study aimed to compare the anterior and posterior methods of hip replacement after six months of surgery in terms of biomechanical and clinical indicators, as well as quality of life. Methods: In this cross-sectional observational study, 42 patients who underwent hip replacement surgery using either the anterior (n = 22) or posterior method (n = 20) at least six months (and a maximum of 12 months) post-surgery, along with 20 healthy individuals, were evaluated. Biomechanical indices of the center of pressure (COP) were measured using a force plate during two-leg standing with eyes open and closed. Functional balance, independence, self-perception of performance, satisfaction, and quality of life were assessed using the timed up and go test (TUG), Barthel Index, Canadian Occupational Performance Measure (COPM), and the SF-36, respectively. Results: No significant differences were found between the anterior and posterior groups in terms of COP, clinical variables, and quality of life (P > 0.05). However, when compared to the control group, the anterior replacement group exhibited significantly higher COP displacement in the medial-lateral direction (P = 0.03) and COP velocity in the anterior-posterior direction (P = 0.02) during two-leg standing with eyes open. No significant differences in COP variables were observed in the posterior replacement group compared to the control group (P > 0.05). Conclusions: The findings indicate no significant differences between the anterior and posterior approaches to hip replacement in terms of biomechanical and clinical indicators, as well as quality of life after six months. Therefore, the choice of surgical method can be based on the patient's condition and the surgeon’s expertise in the respective approach.