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Surgical indications for total hip arthroplasty (THA) are expanding to include increasingly younger patients, yet limited outcomes research has focused on this population. This study compares outcomes between the anterior and posterior approach, as well as between conventional and technology-assisted THA in patients younger than 35-years old. METHODS: A retrospective analysis of 139 primary THAs in 125 patients younger than 35-years old was conducted. Patients were divided into two cohorts: (1) anterior-THA and (2) posterior-THA. A posterior-THA sub-group analysis was performed to compare: (1) technology-assisted THA (tech-THA) versus (2) conventional-THA (con-THA). Demographics, perioperative data, radiographic and clinical outcomes were analyzed using Chi squared and unpaired student t-tests for categorical and continuous variables, respectively. RESULTS: Of the 139 cases performed, 40 were anterior-THA and 99 were posteriorTHA. The anterior-THA cohort had shorter mean surgical time (95.0±25.7 vs. 118.3±43.3 minutes; p<0.01), shorter hospital LOS (1.9±1.4 vs. 2.7±1.2 days; p<0.01), and lower estimated blood loss (EBL) (343.4±164.1 vs. 438.0±272.8 mL; p<0.01) compared to the posterior-THA cohort. There were no statistically significant differences in acetabular component positioning, postoperative limb length discrepancy, clinical outcomes or postoperative complications between cohorts. In the sub-group analysis, cup Health Sciences EPiC Series in Health Sciences Volume 3, 2019, Pages 234–240 CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery P. Meere and F. Rodriguez Y Baena (eds.), CAOS 2019 (EPiC Series in Health Sciences, vol. 3), pp. 234–240 placement within Lewinnek’s Safe Zone was achieved in 78% and 49% of the tech-THA and con-THA groups, respectively (p<0.01). Need for revision THA was significantly higher among the con-THA group (9.4% vs. 0%; p<0.01). CONCLUSION: There is no significant difference in outcomes between anterior and posterior THA among patients under 35-years of age, however, the anterior approach may promote earlier hospital discharge. Technological-assistance can improve component positioning and reduce the rate of early revision and late wear in patients younger than 35 undergoing posterior-THA.

Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach