The Posterolateral Approach is Superior to the Anterior Approach in Total Hip Arthroplasty

Objective This study aimed to evaluate the clinical outcomes of the posterolateral approach (PLA) in patients undergoing primary total hip arthroplasty (THA), with a particular focus on functional recovery and postoperative complications. Methods A retrospective analysis of 800 patients was conducted who underwent primary THA using the posterolateral approach at our hospital from January 2020 to January 2023. Propensity score matching (PSM) was employed to minimize selection bias between the two surgical approaches. Key outcomes assessed included incision length, intraoperative blood loss, operation time, hospital stay, and Harris hip scores at 6 weeks, 3 months, and 6 months postoperatively. Complications occurring within one year were also documented. Results The PLA group demonstrated an average incision length of 13.3 ± 0.2 cm, a hospital stay of 6.2 ± 0.7 days, intraoperative blood loss of 109.1 ± 12.6 ml, and an operation time of 50.6 ± 8.3 minutes. Harris hip scores improved significantly over time, with values of 81.0 ± 0.8 at 6 weeks, 93.4 ± 0.9 at 3 months, and 96.8 ± 1.1 at 6 months. The PLA group demonstrated favorable perioperative outcomes and significant improvement in functional recovery during follow-up. Conclusion The findings demonstrate that the PLA provides favorable surgical efficiency, satisfactory functional recovery, and a low complication rate following THA. These results support the use of the PLA as a preferred surgical approach in THA.