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J Biol Regul Homeost Agents. 2017 Oct-Dec,;31(4 suppl 1):75-81.

Direct anterior approach versus posterolateral approach in total hip arthroplasty: effects on early post-operative rehabilitation period.

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1st Orthopaedic and Traumatologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy
Dipartimento di Ortopedia e Traumatologia, Department of Biomedical Sciences and Morphological and Functional Images, Scuola Ortopedia e Traumatologia, Università di Messina, Italy


Main surgical approaches to the hip have been modified during last decades, in an effort to reduce invasiveness of the surgical procedure and allow a faster rehabilitation. Direct anterior approach is the only approach, which does not require muscle detachment, thus theoretically leading to reduced post-operative pain and allows earlier recovery. The aim of this study was to report a comparison between patients operated with direct anterior approach and postero-lateral approach in terms of immediate post-operative and in-hospital records. Pain, operative time, intra- and post-operative complications, blood loss, hospitalization, motor component of the Functional Independence Measure (M-FIM), timed up and go (TUG) test were measured between the two groups and compared. Direct anterior approach showed better results in M-FIM, TUG, hospitalization and blood loss, without any significant difference for intra- and post-operative complications between the 2 groups. This study shows that early post-operative recovery is influenced by the chosen approach. Direct anterior approach showed better outcomes when compared to postero-lateral approach, limited to hospitalization, blood loss, and functional scores. Further comparisons are needed to evaluate direct anterior approach to maintain advantages over postero-lateral approach on longer follow-up period.


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