ArticleFrontiers in bioengineering and biotechnology2025
AI-assisted direct anterior approach
Article in Frontiers in bioengineering and biotechnology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- [Comparative observation of analgesic efficacy between liposomal bupivacaine and "cocktail" therapy following artificial intelligence-assisted direct anterior approach total hip arthroplasty: A prospective randomized controlled study].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Trial
- Robotic-arm assisted total hip arthroplasty using a short metaphyseal filling collared femoral implant through a direct anterior approach: minimum two-year outcomes.Archives of orthopaedic and trauma surgery · 2026Article
- AI-driven 3D virtual surgical planning in total hip arthroplasty: a machine learning approach for precision implant positioning and improved clinical outcomes.Journal of orthopaedic surgery and research · 2026Article
- [Advances in application of digital orthopedic technology in total hip arthroplasty for developmental dysplasia of hip].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Clinical and radiographic factors associated with surgical approach selection in total hip arthroplasty: a preliminary machine learning analysis.Frontiers in surgery · 2026Article
- AI-assisted 3D versus conventional 2D preoperative planning in total hip arthroplasty for Crowe type II-IV high hip dislocation: a two-year retrospective study.Journal of orthopaedic surgery and research · 2025Article
- Low preserved proximal femoral bone stock volume as a risk factor for periprosthetic femoral fractures. A study of 90 femurs.Frontiers in surgery · 2025Article
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Authors and funding
7 authors.
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Abstract
Objective: To compare the accuracy of implant positioning and early functional recovery between direct anterior approach (DAA) and posterolateral approach (PLA) in total hip arthroplasty (THA) guided by an artificial intelligence preoperative planning system (AIHIP). Methods: The study population consisted of 206 patients who underwent DAA surgery and 81 patients who underwent PLA surgery, all of whom were designed preoperatively using AI-HIP, and postoperatively using artefact-reduced CT reconstruction for prosthesis mounting angle measurements and follow-up such as postoperative outcomes. The main assessments included prosthesis positioning accuracy (compared to the preoperative plan): acetabular anterior inclination (AA), femur anterior inclination (FNA), combined anterior inclination (CA), alignment of femoral stem prosthesis and femur; clinical outcomes: operative time, hospital stay, and time to grounding; functional scores: Harris Hip Score, WOMAC, and VAS Pain Score; and biomarkers: haemoglobin, CRP, and IL-6, among others. Results: All 287 patients completed ≥6-month follow-up. While preoperative femoral/acetabular anteversion showed no intergroup differences (p > 0.05), the direct anterior approach (DAA) demonstrated superior postoperative acetabular anteversion control (20.93 ± 7.54° vs. 24.34 ± 7.93°, p < 0.001) despite comparable femoral anteversion (12.97 ± 6.93° vs. 14.56 ± 7.21°, p = 0.009). AI-assisted predictions exhibited smaller deviations in DAA for both parameters (FNA: 3.12 ± 5.88° vs. 5.59 ± 8.21°, p = 0.005; AA: 0.93 ± 7.54° vs. -4.34 ± 7.93°, p < 0.001). No significant differences emerged in combined anteversion, acetabular abduction, or femoral stem alignment parameters (all p > 0.05). DAA achieved shorter incisions (10.64 ± 0.94 vs. 15.21 ± 1.33 cm, p < 0.001) and hospital stays (7.59 ± 4.18 vs. 9.09 ± 3.65 days, p < 0.001) despite longer operative times (118.67 ± 26.95 vs. 53.27 ± 58.71 min, p < 0.001). Functional recovery favored DAA, with better VAS/Harris scores at 3 months and WOMAC scores at 1 month (all p < 0.05). No intergroup differences were observed in postoperative CK, CRP, Hb, or IL-6 levels (p > 0.05). Conclusion: Both DAA and PLA approaches resulted in satisfactory postoperative outcomes; however, the DAA approach demonstrated enhanced early postoperative efficacy indicators, as well as improved femoral neck and acetabular anteversion compared to the PLA approach. This study advocates for the preferential adoption of the DAA technique for THA, while also emphasizing the importance of considering individual patient factors, as well as the surgeon's preferences and expertise.
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