Direct Anterior Versus Posterior Total Hip Arthroplasty Surgical Approaches

Hip replacement is a common surgical procedure performed to relieve the pain and disability.
In general, the surgery consists of replacing the diseased or damaged joint surfaces of the
hip with metal and plastic components shaped to allow continued motion of the hip. Surgeons
may perform this operation in several different ways. The purpose of this study is to
compare two different methods of performing total hip replacement. The investigators
hypothesize that subjects treated with the anterior approached may show improved function
during the early postoperative period, but that no differences in pain or function will be
present after the first postoperative year.

In this study, patients that have elected to have hip replacement and consented to
participate in the study will be randomized to have his or her hip replaced using one of two
surgical techniques. Subjects will be randomized to be implanted using either an anterior or
posterior approach. With the anterior approach, the study surgeon will use an incision that
is on the front of the hip, and with the posterior approach, the incision will be more on
the backside of your hip. The study surgeon has done more than 300 total hip replacements
with both of these techniques.

A baseline assessment will be conducted before hip replacement surgery that includes x-rays,
functional tasks like getting up from a chair and stepping down a step, and three
questionnaires about the hip, the subject's general health, and how well the subject is able
to function. Also, subjects will be required to return to the clinic at several time points
after surgery for follow-up visits. Follow-up visits will include hip assessments and
questionnaires, as well as follow-up hip x-rays. The follow-up visits will be 6 weeks, 3
months, 1 year, 2 years, 5 years, 7 years, and 10 years after hip replacement surgery. These
follow-up visits are part of the study surgeon's normal routine for hip replacement
patients, and are not extra visits as a part of this study.