Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results

Table 1 Summary of select outcomes reported in the literature in comparative studies of direct anterior and other total hip approaches

Author	Study variable
	Length of stay	Discharge to home	Post-operative pain	Short-term functional outcome	Long-term functional outcome	Blood loss	Operative time
Alecci	↓	↑	↓			↔	↔
Barrett	↓		↓	↑	↔	↑	↑
Berend	↔	↑		↑	↔	↑	↔
D'Arrigo	↔			↑	↔	↓	↑
Goebel	↓		↓
Lamontagne				↔	↔
Martin	↓	↔		↑	↔	↔	↑
Mayr				↑	↔
Poehling-monaghan	↔	↔	↑	↔	↔		↑
Rathod				↔	↔
Rodriguez	↔		↔	↑	↔
Spaans	↔			↔	↔	↑	↑
Taunton				↑	↔
Zawadsky	↓	↑	↓	↑

Arrows indicate relative magnitude of the variable (i.e., ↑: Increased; ↓: Decreased; ↔: Similar) for direct anterior approach compared to alternative approach for applicable study.

Table 2 Summary of select complications reported in the literature in comparative studies of direct anterior and other total hip approaches n (%)

Author	Complications
	Approach	No. patients	Dislocation	Femur fracture	Great trochanter fracture	Hematoma	Ankle injury	Nerve injury	Reoperation due to infection	Reoperation - other than infection	Bursitis	Superficial infection/wound complication	Acetabulum (or pelvis) fracture
Alexandrov	A	43	1 (2.3)	1 (2.3)	5 (11.6)	1 (2.3)	0	2 (4.7)
Amile	A	421	13 (3.1)					25 (5.9)	5 (1.2)	8 (1.9)
	L	431	16 (3.7)					27 (6.3)	8 (1.9)	21 (4.9)
	P	421	10 (2.4)					14 (3.3)	5 (1.2)	7 (1.7)
Bal	A	100		1 (1.0)				4 (4.0)
Barrett	A	43	0 (0.0)	0 (0.0)		1 (2.3)					0 (0.0)	1 (2.3)
	P	44	1 (2.3)	1 (2.3)		0 (0.0)					1 (2.3)	0 (0.0)
Berend	A	258		4 (1.6)				2 (0.8)		2 (0.8)
	L	375				2 (0.5)		2 (0.5)	1 (0.3)			1 (0.3)	1 (0.3)
Bhandari	A	1277	8 (0.6)	22 (1.7)	13 (1.0)	5 (0.4)		13 (1.0)	3 (0.2)	32 (2.5)	1 (0.1)	22 (1.7)	8 (0.6)
Christensen	A	505							3 (0.6)	2 (0.4)		2 (0.4)
	P	1288							1 (0.1)	1 (0.1)
De Geest	A	300	2 (0.7)	12 (4.0)	3 (1.0)			16 (5.3)	6 (2.0)	14 (4.7)		6 (2.0)
Hallert	A	200	4 (2.0)	3 (2.0)				3 (2.0)	1 (1.0)
Hoell	A	113	0 (0.0)	1 (0.9)					1 (0.9)	3 (2.7)
Keggi	A	687	17 (2.5)	15 (2.2)	5 (0.7)	13 (1.9)		5 (0.7)	1 (0.1)
Jewett	A	800	7 (0.9)	24 (3.0)			0 (0.0)	1 (0.1)	7 (0.9)	19 (2.4)			1 (0.1)
Kennon	A	2222	28 (1.3)	63 (2.8)	24 (1.1)	31 (1.4)		9 (0.4)	7 (0.3)				3 (0.1)
Martin	A	41	1 (2.4)	1 (2.4)				7 (17.1)			3 (7.3)	3 (7.3)
	P	47	3 (6.4)	0 (0.0)				0 (0.0)			7 (14.9)	4 (8.5)
Matta	A	494	3 (0.6)	6 (1.2)	3 (0.6)	3 (0.6)	3 (0.6)	1 (0.2)	1 (0.2)	3 (0.6)
Mirza	A	258	4 (1.5)	9 (3.5)					1 (0.4)
Reichert	A	85	0 (0.0)					6 (7.1)		1 (1.2)	1 (1.2)
	L	86	0 (0.0)	1 (1.2)					1 (1.2)	1 (1.2)
Sariali	A	1764	27 (1.5)	28 (1.6)	1 (0.1)					3 (0.2)
Spaans	A	46	1 (2.2)							3 (6.5)			1 (2.2)
	P	46	1 (2.2)							0 (0.0)			1 (2.2)
Wayne	A	100	2 (2.0)	8 (8.0)				6 (6.0)	0 (0.0)	5 (5.0)		0 (0.0)	3 (3.0)
	L	100	1 (1.0)	2 (2.0)				0 (0.0)	3 (3.0)	3 (3.0)		4 (4.0)	1 (1.0)
Yi	A	61	1 (1.6)	2 (3.3)	3 (4.9)	1 (1.6)		1 (1.6)	1 (1.6)	2 (3.3)
Zawadsky	A	100	0 (0.0)						2 (2.0)	3 (3.0)
	P	50	1 (2.0)						3 (6.0)	0 (0.0)

A: Anterior; L: Lateral; P: Posterior.