Gait analysis and clinical outcomes of anterior and lateral approach total hip arthroplasty: A prospective randomized study

Objectives: This study compared the lateral and direct anterior approaches (DAAs) for total hip arthroplasty (THA) regarding gait analysis and post-operative outcomes. Methods: Patients undergoing THA for osteonecrosis or primary osteoarthritis were randomized to either the lateral or DAA. Standardized surgical procedures and implants were used. Gait analysis, including temporal distance parameters, kinetics, and kinematics, was conducted at 6 weeks, 3 months, and 18 months. Results: Thirty-four patients (16 lateral, 18 anterior) participated, with comparable demographics. At 6 weeks, the anterior approach group had significantly higher Harris hip scores, improved gait speed, greater hip extension and external rotation moments, higher peak hip abduction angle, and reduced peak hip extension angle. The lateral approach (LA) group showed decreased hip abduction and internal rotation moments. By 3 and 18 months, outcomes were similar between groups. Conclusion: The anterior approach facilitates faster rehabilitation at 6 weeks, but outcomes converge with the LA by 3 and 18 months postoperatively.