Comparison of Early Functional Outcomes and Gait Following Total Hip Arthroplasty through Lateral and Posterior Approaches: A Prospective Study in a Tertiary Care Hospital

Background: The study compares early functional outcomes and gait following Total Hip Arthroplasty (THA) through lateral (Hardinge) and posterior (Moore) approaches in 60 patients diagnosed with end-stage hip disorders. Conducted at a tertiary care hospital, patients were equally divided into two groups, with assessments performed at various postoperative intervals using the Harris Hip Score (HHS), gait evaluation, and pain measurement via the Visual Analogue Scale (VAS). Material and Methods: Both approaches improved hip function and quality of life significantly over time. However, the posterior approach demonstrated notably superior functional recovery and gait restoration, with higher HHS scores at 6 weeks (75.8 vs. 70.6, p=0.004) and 3 months (88.1 vs. 84.2, p=0.01). At 3 months, 80% of patients in the posterior group achieved a normal gait compared to 60% in the lateral group (p=0.048). Lower pain scores were also noted in the posterior approach, and it facilitated a greater range of motion, particularly in hip flexion (113° vs. 108°, p=0.03). Results: The lateral approach was associated with a shorter operative time (76.5 vs. 82.1 minutes, p=0.03) but resulted in more significant postoperative limp and Trendelenburg positivity, though this did not reach statistical significance. Complication rates were low and comparable across both groups, with no dislocations in the lateral approach. Conclusion: Both surgical methods are effective for THA, but the posterior approach offers advantages in early functional recovery and gait improvement, while the lateral approach provides a faster surgery time and robust joint stability. Future multicenter, randomized trials with larger sample sizes and extended follow-up are warranted to confirm these findings and guide surgical decision-making.

Keywords: Arthroplasty, Fracture, Hip, Rehabilitation, Restoration, Bone.