A Comparison of Hospital Length of Stay and Short-term Morbidity Between the Anterior and the Posterior Approaches to Total Hip Arthroplasty

The efficacy of the anterior, relative to other operative approaches, in promoting earlier return to function after hip arthroplasty has not been well established. We retrospectively compared 41 anterior and 47 posterior approach cases. Mean hospital stay (2.9 vs. 4 days, p = 0.001) and days to mobilization (2.4 vs. 3.2 days, p = 0.006) were shorter with the anterior approach. After multivariate regression, the anterior approach remained a significant predictor of early discharge (p = 0.009). Lateral femoral cutaneous nerve neuropraxia (17%) and fracture (2%), were more common in the anterior cohort, but all patients recovered without sequela. Overall, the anterior approach patients had earlier discharge and mobilization as compared to patients who received the posterior approach. Neuropraxia and fracture remain a concern, but the clinical significance was low in our cohort.