title: Functional and clinical outcomes following anterior hip replacement: a 5-year comparative study versus posterior approach.
abstract: BACKGROUND
  With the evolution of total hip joint replacement techniques, there has been a trend towards minimally invasive surgery. The anterior approach (AA) to total hip arthroplasty has been widely associated with less soft tissue damage. The aim of our study was to compare clinical and 1-year functional outcomes for AA hip arthroplasty versus a posterior approach (PA).
  
  
  METHODS
  We retrospectively reviewed 92 (50 anterior and 42 posterior) total hip replacements performed at our centre between 2006 and 2011. Clinical outcomes were recorded from hospital medical records and clinical audit system. Range of motion analysis, Harris hip score (HHS) and Short Form-12 score were recorded pre-operatively and at the 12-month follow-up marks. Additionally, we reviewed operative time, length of stay, discharge destination, complications, return to theatre and readmission rates.
  
  
  RESULTS
  The results of our study revealed significantly shorter average hospital length of stay for the AA versus PA (4.2 versus 6.0 days, P = 0.004). Interestingly, our study also showed significantly shorter operating time with the AA (83.0 versus 91.8 min, P = 0.048) and lower return to theatre rates (0 versus 9.5%, P = 0.026). Finally, multivariate analysis showed AA to be associated with higher HHS and pre-operative body mass index to be associated with lower HHS at 12-month post-operation (P = 0.02 and <0.001, respectively).
  
  
  CONCLUSIONS
  Our study showed improved HHS at 12 months as well as reduced hospital length of stay, operating time and return to theatre with an AA when compared with a PA.
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: Umatheepan
authors.initials: U
authors.lastname: Balasubramaniam
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Dowsey
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Francis
authors.initials: F
authors.lastname: Ma
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dunin
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Choong
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology
keywords: anterior; hip; outcomes; posterior; replacement