I have started doing the research on surgical approach for THR as I have fairly severe OA on MRI and will need surgery at some point. Having said that my pain levels are currently fairly low having had my valgus right leg straightened with a partial knee replacement.
At a recent follow up I asked my surgeon ( who does equal numbers of hips and knees and did an excellent job on my knee) his views on hip approach.
He does posterior, anterior and dual- mobility depending on patient anatomy.
He told me the following.
He thinks that the advantages of the anterior approach are oversold in terms of early recovery and the risk of dislocation ( which should be extremely low in the right hands and if the patient is sensible). He said his dislocation rate was less than 1/200 (0.5%). There is also a higher risk of nerve damage and bone fracture plus an area of numbness that is hard to avoid.
He does dual mobility implants in patients who are at high risk of dislocation. In his view this may turn out to be the best approach for everyone but the jury is still out on this. The two surfaces mean there is more area for wear and tear and it is not clear if these implants will last as well.
I am currently doing lots of pilates/ muscle strengthening and seeing him again in a year to keep my hips under review.
I wouldn't necessarily rule out a posterior approach.
If you are in the UK look at the surgeon's figures on the NJR ( National Joint Registry).
My surgeon is Alex Liddle ( Charing X/ King Edward's).
He did an amazing job on my knee and I will definitely trust him to do my hip if/ when it needs doing.