ArticleScientific reports2021
Clinical evaluation of direct anterior approach total hip arthroplasty for severe developmental dysplasia of the hip.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of direct anterior vs. posterior approach in primary total hip arthroplasty: a systematic review and meta-analysis on enhanced recovery after surgery.Frontiers in surgery · 2025Pooled it
- Long-Term Prosthesis Survival After Total Hip Arthroplasty in Young Women with Developmental Dysplasia of the Hip: A Narrative Review of Instability, Revision Risk, and Reproductive Health Considerations.Journal of clinical medicine · 2026Review
- Clinical and Safety Outcomes after Direct Anterior Total Hip Arthroplasty Compared with Conventional Approaches: A Systematic Review and Meta-Analysis.Journal of orthopaedic case reports · 2026Review
- Comparative analysis of the quality of life regarding patients who underwent hip replacement in public versus private hospitals in Hungary.Scientific reports · 2024Article
- Subtrochanteric Osteotomy in Direct Anterior Approach Total Hip Arthroplasty for Crowe IV Dysplasia-Surgical Technique and Literature Review.Orthopaedic surgery · 2024Review
- Extra-articular blocking technique for acetabular bone defect reconstruction.Annals of joint · 2024Article
- Extra-articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip.Orthopaedic surgery · 2023Observational
- Direct anterior versus posteriorlateral approachs for clinical outcomes after total hip arthroplasty in the treatment of severe DDH.BMC musculoskeletal disorders · 2022Article
- Direct anterior approach in total hip arthroplasty: more indications and advantages than we found.Arthroplasty (London, England) · 2022Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It is challenging to treat developmental dysplasia of the hip (DDH) classified Crowe III-IV using direct anterior approach (DAA) total hip arthroplasty (THA), and very little is known on its outcome. This study aimed to investigate the clinical result in this defined disorder with DAA versus posterolateral approach. Twenty-three consecutive hips with Crowe III-IV DDH who underwent DAA were retrospectively evaluated from 2016 through 2018. Outcomes were primarily assessed by HHS, WOMAC, and SF-12 physical scales. The second evaluations included leg length discrepancy, hip muscle strength, radiographic review, complications, and limp recovery. Results were compared to a control cohort of 50 hips underwent posterolateral THA concurrently within the observational period. At last follow-up (DAA 28.5 months; PLA 39.0 months), the mean increase of the HHS for DAA was 48.2 and 30.3 for PLA (p = 0.003). The improvement in WOMAC score in DAA cohort was 15.89 higher that of the PLA cohort after adjusting preoperative difference [R2 = 0.532, P = 0.000, 95% CI (10.037, 21.735)]. DAA had more rapid recovery of hip abductor strength at 1-month (p = 0.03) and hip flexor strength at 3 months (p = 0.007) compared to PLA. No significant differences were found in the radiographic analysis with the exception of increased acetabular anteversion in the DAA cohort (p = 0.036). Satisfactory improvement in limp, indicated by the percentage of limp graded as none and mild to the total, was much higher in DAA cohort (97.6%), compared to that of PLA cohort (90.0%, p = 0.032). DAA for high-dislocated dysplasia demonstrate a significant improvement in clinical result comparable to posterolateral approach. Improved clinical outcome in terms of increased HHS and WOMAC scores, rapid recovery of hip abductor and flexor strength, and enhanced limp recovery without an increased risk in complications, could be acquired when the surgeons were specialized in this approach.
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