Favorable Radiographic and Early Postoperative Results with the Inguinal Crease Direct Anterior Total Hip Arthroplasty


We report the results, scar appearance, and patient satisfaction of a direct anterior approach total hip arthroplasty performed through an oblique inguinal incision. Patients were separated into direct anterior THA (n = 29) or an oblique inguinal incision anterior approach (n = 41). Clinical and radiographic data was compared, scar appearance was assessed by the Vancouver Scar Scale (VSS), and satisfaction was assessed by a simple questionnaire. Harris Hip Scores significantly improved in each group (1.8×10-8) and improved similarly between groups (p ≥ 0.35). The VSS score was lower in the inguinal incision versus the standard incision group (0.68 [range 0–3] vs. 1.56 [range 0–4], p = 0.015). Scar satisfaction was higher in the inguinal incision group with 87% compared to only 32% in the standard approach. The inguinal incision approach was safe, offered similar postoperative results, and resulted in improved patient scar satisfaction compared to the standard anterior approach by using an incision that more closely resembled normal anatomy. (Journal of Surgical Orthopaedic Advances 31(1):056–060, 2022)

Key words: anterior approach, inguinal incision, minimally invasive, total hip replacement

Bradford S. Waddell, MD; Jesse A. Raszewski, DO, MBS; Kwesi G. Dawson-Amoah, MD; Imraan A. Khan, BS; and Edwin P. Su, MD