Direct Anterior Versus Posterior Approach in Total Hip Arthroplasty: A Literature Review Comparing Outcomes, Functional Recovery, and Return to Sports

Hip osteoarthritis is becoming an increasingly serious and common problem. Global trends indicate a steadily rising number of people affected by this condition. At the same time, there is a gradually increasing need for treatment of this condition among younger demographic groups. This leads to an increasing need for research on the outcomes of total hip arthroplasty. The aim of this literature review is to compare the outcomes of procedures performed using the direct anterior and direct posterior approaches, taking into account an analysis of patients’ ability to return to full function and intraoperative parameters. The study is based on the results of studies, including meta-analyses and reviews, identified and selected using the PubMed, Cochrane, Embase, and Google Scholar databases. To ensure the appropriate quality of the analyzed studies and to present the current state of medical knowledge in the review, it was decided to apply exclusion criteria considering the publication date, objective, and methodological quality of the studies. Evidence from the analyzed studies indicates significant differences in the profile of complications, intraoperative parameters, and muscle damage between direct anterior access and posterior access. The findings suggest that the choice of approach does not affect residents’ learning curve. The studies demonstrated that regardless of the chosen approach, patients undergoing total hip arthroplasty can return to physical activity, which is a particularly important factor for young patients undergoing arthroplasty. Although both approaches constitute a safe standard of care for hip osteoarthritis, the analysis highlighted the ongoing need to study the impact of surgical approach selection on patients’ return to sports activities and postoperative pain management protocols. The choice of surgical technique should be based not only on the patient’s anatomy but also on their activity level.