Trial reportActa orthopaedica2018
Early gain in pain reduction and hip function, but more complications following the direct anterior minimally invasive approach for total hip arthroplasty: a randomized trial of 100 patients with 5 years of follow up.
Trial report in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 10 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Early clinical efficacy and safety of different surgical approaches in total hip arthroplasty: a systematic review and network meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Postoperative Harris Hip Score Versus Harris Hip Score Difference in Hip Replacement: What to Report?Orthopaedic surgery · 2025Pooled it
- Indirect comparisons of traction table versus standard table in total hip arthroplasty through direct anterior approach: a systematic review and frequentist network meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Evaluation of Comparative Efficacy and Safety of Surgical Approaches for Total Hip Arthroplasty: A Systematic Review and Network Meta-analysis.JAMA network open · 2023Pooled it
- Short-term outcomes vary by surgical approach in total hip arthroplasty: a network meta-analysis.Archives of orthopaedic and trauma surgery · 2022Pooled it
- A meta-analysis on RCTs of direct anterior and conventional approaches in total hip arthroplasty.Scientific reports · 2021Pooled it
- The learning curve for the direct anterior total hip arthroplasty: a systematic review.International orthopaedics · 2021Pooled it
- Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2021Pooled it
- Pooled it
- Comparison of the early clinical efficacy of the SuperPath approach versus the modified Hardinge approach in total hip arthroplasty for femoral neck fractures in elderly patients: a randomized controlled trial.Journal of orthopaedic surgery and research · 2023Trial
- Comparative study of suction drainage placement in cementless hip replacement among patients undergoing extended thromboprophylaxis: a prospective randomized study.BMC musculoskeletal disorders · 2021Trial
- Article
- [Comparison of Abductor Muscle Strength and Harris Hip Score after Total Hip Arthroplasty].Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2025Article
- Dislocation incidence and risk factors following direct anterior primary total hip arthroplasty: a consecutive, single-surgeon cohort.BMC musculoskeletal disorders · 2025Article
- More intraoperative complications but similar revision rate in primary total hip arthroplasties using direct anterior approach in supervised trainees-a retrospective cohort study.Archives of orthopaedic and trauma surgery · 2024Article
- Enhancing recovery: surgical techniques and rehabilitation strategies after direct anterior hip arthroplasty.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Review
- A Comparison of Wound Complications Following Total Hip Arthroplasty Performed Through the Direct Anterior Versus Direct Lateral Approach.Arthroplasty today · 2024Article
- Improved patient reported outcomes with the direct anterior approach versus the posterior approach for total hip arthroplasty in the early post-operative period.Archives of orthopaedic and trauma surgery · 2024Article
- Which approach of total hip arthroplasty is the best efficacy and least complication?World journal of orthopedics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - The minimally invasive direct anterior (DA) approach for total hip arthroplasty (THA) is supposed to reduce surgical tissue trauma. We hypothesized that patients operated with the DA technique would have less postoperative pain and better hip function compared with a group operated with a conventional direct lateral (DL) approach. Patients and methods - 100 patients with hip osteoarthritis scheduled for THA were equally randomized to surgery through either DA or DL. Pain was assessed on a VAS scale, hip function with TUG, 10mWT, HHS, and quality of life with EQ-5D. Patients were followed up after the first 3 days, 8 weeks, and at 1 and 5 years postoperatively. Results - The DA group registered less pain with activity on the second day (VAS 42 vs. 55), performed TUG 6 seconds faster on the third day and had 8 points higher HHS and higher EQ-5D index (0.86 vs 0.78) at 8 weeks; all differences were statistically significant. No clinically relevant differences between groups in pain, hip function, or quality of life were seen at 1 or 5 years. 7 surgical approach related complications appeared in the DA group, none in the DL. Interpretation - The results indicate that the presumably less traumatic approach results in reduced immediate postoperative pain and better hip function and higher quality of life in the early postoperative period. However, this positive effect is not seen at later time points. Instead, complications appear to be over-represented, thus questioning the use of the method.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.