The benefits of different surgical approaches for total hip arthroplasty continue to be debated. One hundred patients were prospectively enrolled and randomized into 2 groups. One group underwent total hip arthroplasty through a single-incision modified Smith-Peterson approach, whereas the other group underwent total hip arthroplasty through a direct lateral approach. All patients received the same postoperative protocol. Evaluation included operative time, estimated blood loss, analgesia requirement, transfusions, and length of stay. Functional outcome was assessed preoperatively and postoperatively. Up to 1-year follow-up, the direct anterior group demonstrated significantly better improvement in both the mental and physical health dimensions of Short Form-36 and Western Ontario McMaster Osteoarthritis Index compared with direct lateral approach group. At 2 years, the results in both groups were the same.
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