A Comparative Study of Functional Outcome Following Total Hip Replacement by Posterolateral and Anterolateral Approach.

Introduction: Total hip arthroplasty (THA) is a conclusive intervention for advanced avascular necrosis (AVN) of the femoral head. The anterolateral and posterolateral surgical methods are the most frequently employed; yet the ideal approach remains debated. The present study compared functional outcomes, pain relief, and post-operative complications between the anterolateral and posterolateral approaches in patients undergoing THA. Materials and Methods: This prospective-retrospective observational study was conducted on 60 patients diagnosed with stage III and IV AVN of the femoral head who underwent THA. Patients were divided into the anterolateral (n = 29) and posterolateral (n = 31) groups. Functional results were evaluated using the Harris Hip Score (HHS), and pain was measured using the Visual Analog Scale (VAS). Follow-up was performed at 1 and 6 months post-operatively. Results: Both techniques showed statistically significant improvements in HHS and reductions in VAS scores over time (P < 0.001). Pre-operative functional and pain scores were similar between the two groups. The anterolateral approach resulted in significantly higher HHS and lower VAS scores than the posterolateral approach at 1 and 6 months post-operatively (P < 0.05). Post-operative complications were infrequent and did not differ between the two groups. Conclusion: Both anterolateral and posterolateral approaches are safe and effective for the treatment of AVN of the femoral head by THA. The anterolateral approach allows for better early functional recovery and pain relief, but the overall complication rates are similar. The surgeon's experience and the patient's individual characteristics should determine the surgical approach.