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J Arthroplasty. 2009 Aug;24(5):698-704. doi: 10.1016/j.arth.2008.04.012. Epub 2008 Jun 13.

A clinical comparative study of the direct anterior with mini-posterior approach: two consecutive series.

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Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Osaka, Japan.


We classified 182 consecutive patients (195 hips) treated by primary cementless minimally invasive total hip arthroplasty (MIS-THA) into 2 groups via the surgical approaches: direct anterior approach (DAA, 99 hips) and a mini-posterior approach (MPA, 96 hips). Ninety-nine percent of the cups in the DAA group and 91% in the MPA group had been implanted within the safe zone (P = .008). Patients in the DAA group could get single-leg stance of more than 5 seconds by 16.6 days (P = .0004), had positive Tredelenburg's sign by 29%, got 50-m walking time of 52.3 seconds (P = .017), and showed improvement in the use of assistive walking aids (P = .031) at 3 weeks postoperatively. The results of this study suggest more rapid recovery for hip function and gait ability after MIS-THA via a DAA when compared to an MPA.

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