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Background  The impact of handedness on clinical outcomes was easily overlooked in hip replacement. This study aimed to find whether the component positioning and hip function were affected by the handedness in total hip arthroplasty (THA) through direct anterior approach (DAA).    Methods  Total 102 patients who underwent bilateral DAA-THAs simultaneously between May 2016 and November 2018 in our institute were reviewed. All surgeries were operated by one right-handed surgeon. Their demographic, cup positioning, stem alignment, femoral stem fit, Harris hip score (HHS), intraoperative and postoperative complications were used to evaluate the role of handedness in DAA.    Results  The inclination of left cups was significantly larger than that of right cups (42.61 ± 7.32 vs 39.42 ± 7.19,  p  = 0.000). The stem fit of left femur was significantly larger than that of right femur (84.34 ± 4.83 vs 82.81 ± 6.07,  p  = 0.043). No significant differences in safe zone ratio, HHS and complications between bilateral hips were found.    Conclusions  A surgeon’s handedness had significant impact on cup’s inclination and femoral stem fit in DAA-THA. However, there were no significant differences of cup malpositioning, stem alignment, hip function scores and complications between bilateral DAA-THAs.

A Surgeon’s handedness in direct anterior approach-hip replacement