Comparison of direct anterior versus posterolateral approach total hip arthroplasty for developmental dysplasia of the hip: A clinical effectiveness retrospective study

The aim of this study was to evaluate the clinical efficacy of 2 approaches to total hip arthroplasty-the direct anterior approach and the posterolateral approach-in the treatment of developmental dysplasia of the hip. A total of 201 patients who were hospitalized between 2018 and 2023 for this condition were included in the study. Of the total number of patients, 100 underwent the procedure via the direct anterior approach (study group), whereas 101 underwent total hip arthroplasty via the posterolateral approach (control group). A range of clinical and patient data was gathered, including the following: age, gender, body mass index, disease classification, symptom history, intraoperative blood loss, blood transfusion volume, incision length, operation time, hospital stay, visual analog scale score, Harris score, Barthel index, postoperative complications, follow-up time, leg length discrepancy, and femur offset difference. The lack of statistically significant variations in age, gender, body mass index, and symptom history among the 2 patient groups suggests that they were comparable. Nevertheless, notable disparities were observed between the groups with regard to the length of the surgical incision (P < .001) and intraoperative blood loss (P < .001). Significant differences (P < .001) were observed in the visual analog scale scores of the patients in the study group at 1 day (6.71 ± 0.46), 3 days (5.71 ± 0.46), and 1 week (0.96 ± 0.20) after surgery, in comparison with the control group (7.46 ± 0.51, 6.35 ± 0.49, 1.73 ± 0.67). In addition, notable distinctions were detected in the Harris score between the groups at the Harris score 3 months postsurgery (P < .001) and at the last follow-up (P = .012). Furthermore, noteworthy distinctions were observed in the study group regarding both preoperative and postoperative leg length discrepancy (P < .001), in addition to preoperative offset and postoperative offset (P < .001). The utilization of the direct anterior approach in total hip replacement presents several advantages, including reduced tissue damage, decreased pain, quicker postoperative functional recovery, reduced dislocation risk, and enhanced hip joint functionality. This approach is in accordance with the tenets of minimally invasive surgery and improved recovery protocols, rendering it a feasible option for the management of developmental dysplasia of the hip among individuals.