Financial impact of total hip arthroplasty: a comparison of anterior versus posterior surgical approaches

BACKGROUND: Compared to the posterior approach, the anterior approach to total hip arthroplasty (THA) offers the potential for an accelerated recovery secondary to less dissection and therefore less pain in the immediate postoperative period. This offers potential financial benefit through a reduction in length of stay. This study retrospectively reviewed 98 anterior approach and 69 posterior approach THA cases (N = 167) to compare perioperative outcomes and cost-effectiveness. METHODS: Patients who underwent anterior approach THA were discharged sooner than those who underwent posterior approach THA. RESULTS: The anterior approach was also less expensive per patient than the posterior approach. Overall, differences in perioperative outcomes between these approaches to THA are less robust than previously reported. There is a significant difference in operative cost between these surgical approaches. CONCLUSIONS: Although there are many sources for this difference in cost, the predominant contributor is surgeon implant preference.