{"id":"https://openalex.org/W7204694167","doi":"https://doi.org/10.1007/s44411-026-00830-9","title":"Direct Anterior Approach is Associated with Superior Postoperative Sexual Function Compared with Anterolateral Approach in Men Undergoing Total Hip Arthroplasty: A Prospective Cohort Study","display_name":"Direct Anterior Approach is Associated with Superior Postoperative Sexual Function Compared with Anterolateral Approach in Men Undergoing Total Hip Arthroplasty: A Prospective Cohort Study","publication_year":2026,"publication_date":"2026-08-30","ids":{"openalex":"https://openalex.org/W7204694167","doi":"https://doi.org/10.1007/s44411-026-00830-9"},"language":"en","primary_location":{"id":"doi:10.1007/s44411-026-00830-9","doi":"https://doi.org/10.1007/s44411-026-00830-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44411-026-00830-9","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44411-026-00830-9.pdf","source":{"id":"https://openalex.org/S2756093218","display_name":"Bratislavsk\u00e9 lek\u00e1rske listy/Bratislava medical journal","issn_l":"0006-9248","issn":["0006-9248","1336-0345"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Bratislava Medical Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://link.springer.com/content/pdf/10.1007/s44411-026-00830-9.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5096857698","display_name":"Szabo Miklos","orcid":"https://orcid.org/0000-0003-4571-1503","observed_orcids":["https://orcid.org/0000-0003-4571-1503"]},"institutions":[{"id":"https://openalex.org/I4400573207","display_name":"Nemocnica Bory, a.s","ror":"https://ror.org/05mkckz37","country_code":"SK","type":"healthcare","lineage":["https://openalex.org/I4400573207"]}],"countries":["SK"],"is_corresponding":true,"raw_author_name":"Szab\u00f3 Mikl\u00f3s","raw_affiliation_strings":["Department of Orthopedics, Hospital Bory, Bratislava, Slovakia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Hospital Bory, Bratislava, Slovakia","institution_ids":["https://openalex.org/I4400573207"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036435458","display_name":"J. Alm\u00e1si","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4400573207","display_name":"Nemocnica Bory, a.s","ror":"https://ror.org/05mkckz37","country_code":"SK","type":"healthcare","lineage":["https://openalex.org/I4400573207"]}],"countries":["SK"],"is_corresponding":true,"raw_author_name":"Alm\u00e1si Jozef","raw_affiliation_strings":["Department of Orthopedics, Hospital Bory, Bratislava, Slovakia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopedics, Hospital Bory, Bratislava, Slovakia","institution_ids":["https://openalex.org/I4400573207"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139671703","display_name":"Igor Bartl","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210095125","display_name":"University Hospital Bratislava","ror":"https://ror.org/00pspca89","country_code":"SK","type":"healthcare","lineage":["https://openalex.org/I4210095125"]}],"countries":["SK"],"is_corresponding":false,"raw_author_name":"Bartl Igor","raw_affiliation_strings":["Department of Urology, Urological and Sexological Clinical Outpatient Clinic, Ru\u017einov Hospital, University Hospital Bratislava, Bratislava, Slovakia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Urology, Urological and Sexological Clinical Outpatient Clinic, Ru\u017einov Hospital, University Hospital Bratislava, Bratislava, Slovakia","institution_ids":["https://openalex.org/I4210095125"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5080319393","display_name":"Boris \u0160te\u0148o","orcid":"https://orcid.org/0000-0003-3220-7455","observed_orcids":["https://orcid.org/0000-0003-3220-7455"]},"institutions":[{"id":"https://openalex.org/I4210095125","display_name":"University Hospital Bratislava","ror":"https://ror.org/00pspca89","country_code":"SK","type":"healthcare","lineage":["https://openalex.org/I4210095125"]}],"countries":["SK"],"is_corresponding":false,"raw_author_name":"\u0160te\u0148o Boris","raw_affiliation_strings":["Department of Orthopaedic and Trauma Surgery, 2nd University, University Hospital Bratislava Saints Cyril and Methodius Hospital, Bratislava, Slovakia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic and Trauma Surgery, 2nd University, University Hospital Bratislava Saints Cyril and Methodius Hospital, Bratislava, Slovakia","institution_ids":["https://openalex.org/I4210095125"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5036435458","https://openalex.org/A5096857698"],"corresponding_institution_ids":["https://openalex.org/I4400573207"],"apc_list":{"value":3590,"currency":"USD","value_usd":3590},"apc_paid":{"value":3590,"currency":"USD","value_usd":3590},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"127","issue":"10","first_page":"4639","last_page":"4651"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10512","display_name":"Orthopaedic implants and arthroplasty","score":0.8920999765396118,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10512","display_name":"Orthopaedic implants and arthroplasty","score":0.8920999765396118,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10562","display_name":"Total Knee Arthroplasty Outcomes","score":0.06509999930858612,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10459","display_name":"Sexual function and dysfunction studies","score":0.017400000244379044,"subfield":{"id":"https://openalex.org/subfields/2738","display_name":"Psychiatry and Mental health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hip-arthroplasty","display_name":"total hip arthroplasty","score":0.996999979019165},{"id":"https://openalex.org/keywords/direct-anterior-approach","display_name":"direct anterior approach","score":0.996999979019165},{"id":"https://openalex.org/keywords/anterolateral-approach","display_name":"anterolateral approach","score":0.9990000128746033},{"id":"https://openalex.org/keywords/sexual-function","display_name":"sexual function","score":0.6859999895095825},{"id":"https://openalex.org/keywords/erectile-function","display_name":"erectile function","score":0.996999979019165},{"id":"https://openalex.org/keywords/hip-osteoarthritis","display_name":"hip osteoarthritis","score":0.847000002861023},{"id":"https://openalex.org/keywords/postoperative-pain","display_name":"postoperative pain","score":0.8669999837875366},{"id":"https://openalex.org/keywords/joint-stiffness","display_name":"joint stiffness","score":0.8140000104904175},{"id":"https://openalex.org/keywords/quality-of-life","display_name":"quality of life","score":0.9470000267028809},{"id":"https://openalex.org/keywords/men","display_name":"men","score":0.44699999690055847},{"id":"https://openalex.org/keywords/surgical-approach-comparison","display_name":"surgical approach comparison","score":0.7680000066757202}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8944000005722046},{"id":"https://openalex.org/C2775871022","wikidata":"https://www.wikidata.org/wiki/Q7458776","display_name":"Sexual function","level":2,"score":0.7519000172615051},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.7319999933242798},{"id":"https://openalex.org/C2776164576","wikidata":"https://www.wikidata.org/wiki/Q62736","display_name":"Osteoarthritis","level":3,"score":0.6363999843597412},{"id":"https://openalex.org/C3020768380","wikidata":"https://www.wikidata.org/wiki/Q133993","display_name":"Erectile function","level":3,"score":0.5270000100135803},{"id":"https://openalex.org/C2779929075","wikidata":"https://www.wikidata.org/wiki/Q184674","display_name":"Erectile dysfunction","level":2,"score":0.5109999775886536},{"id":"https://openalex.org/C3019025420","wikidata":"https://www.wikidata.org/wiki/Q32333487","display_name":"Total hip arthroplasty","level":2,"score":0.5099999904632568},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4887999892234802},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4767000079154968},{"id":"https://openalex.org/C2779951463","wikidata":"https://www.wikidata.org/wiki/Q7268788","display_name":"Quality of life (healthcare)","level":2,"score":0.47510001063346863},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4465999901294708},{"id":"https://openalex.org/C2778336525","wikidata":"https://www.wikidata.org/wiki/Q708178","display_name":"Arthroplasty","level":2,"score":0.42289999127388},{"id":"https://openalex.org/C3020453552","wikidata":"https://www.wikidata.org/wiki/Q32333487","display_name":"Total hip replacement","level":2,"score":0.40709999203681946},{"id":"https://openalex.org/C2775944032","wikidata":"https://www.wikidata.org/wiki/Q22907659","display_name":"Patient satisfaction","level":2,"score":0.4059000015258789},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.397599995136261},{"id":"https://openalex.org/C2778093883","wikidata":"https://www.wikidata.org/wiki/Q1137463","display_name":"Sexual dysfunction","level":2,"score":0.3310000002384186},{"id":"https://openalex.org/C2777092991","wikidata":"https://www.wikidata.org/wiki/Q1107654","display_name":"Sexual desire","level":3,"score":0.30889999866485596},{"id":"https://openalex.org/C3017530563","wikidata":"https://www.wikidata.org/wiki/Q7458776","display_name":"Sexual functioning","level":3,"score":0.3027999997138977},{"id":"https://openalex.org/C111335779","wikidata":"https://www.wikidata.org/wiki/Q3454686","display_name":"Reduction (mathematics)","level":2,"score":0.2768000066280365},{"id":"https://openalex.org/C3020736514","wikidata":"https://www.wikidata.org/wiki/Q32333487","display_name":"Hip arthroplasty","level":3,"score":0.2759999930858612},{"id":"https://openalex.org/C2776237627","wikidata":"https://www.wikidata.org/wiki/Q133549","display_name":"SF-36","level":4,"score":0.262800008058548},{"id":"https://openalex.org/C2992051495","wikidata":"https://www.wikidata.org/wiki/Q32333487","display_name":"Hip surgery","level":3,"score":0.25870001316070557},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2522999942302704}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1007/s44411-026-00830-9","doi":"https://doi.org/10.1007/s44411-026-00830-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44411-026-00830-9","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44411-026-00830-9.pdf","source":{"id":"https://openalex.org/S2756093218","display_name":"Bratislavsk\u00e9 lek\u00e1rske listy/Bratislava medical journal","issn_l":"0006-9248","issn":["0006-9248","1336-0345"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Bratislava Medical Journal","raw_type":"journal-article"},{"id":"doi:10.21203/rs.3.rs-10107642/v1","doi":"https://doi.org/10.21203/rs.3.rs-10107642/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10107642/v1","pdf_url":"https://www.researchsquare.com/article/rs-10107642/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.1007/s44411-026-00830-9","doi":"https://doi.org/10.1007/s44411-026-00830-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44411-026-00830-9","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44411-026-00830-9.pdf","source":{"id":"https://openalex.org/S2756093218","display_name":"Bratislavsk\u00e9 lek\u00e1rske listy/Bratislava medical journal","issn_l":"0006-9248","issn":["0006-9248","1336-0345"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","ki-jl-1","norway-1","poland-20","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Bratislava Medical Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204694167.pdf","grobid_xml":"https://content.openalex.org/works/W7204694167.grobid-xml"},"referenced_works_count":43,"referenced_works":["https://openalex.org/W1855133546","https://openalex.org/W1942576920","https://openalex.org/W2032618951","https://openalex.org/W2044251549","https://openalex.org/W2107749577","https://openalex.org/W2114974973","https://openalex.org/W2125677295","https://openalex.org/W2126577182","https://openalex.org/W2127465589","https://openalex.org/W2137933911","https://openalex.org/W2143061410","https://openalex.org/W2154659002","https://openalex.org/W2167141827","https://openalex.org/W2288322902","https://openalex.org/W2321290461","https://openalex.org/W2462596148","https://openalex.org/W2517434838","https://openalex.org/W2616690241","https://openalex.org/W2620011714","https://openalex.org/W2732410341","https://openalex.org/W2803724758","https://openalex.org/W2939662188","https://openalex.org/W2940870366","https://openalex.org/W2954298495","https://openalex.org/W2989655712","https://openalex.org/W3081013345","https://openalex.org/W3126968992","https://openalex.org/W3190099608","https://openalex.org/W3194502230","https://openalex.org/W3209612780","https://openalex.org/W4200536836","https://openalex.org/W4211145358","https://openalex.org/W4318668286","https://openalex.org/W4327896680","https://openalex.org/W4362506183","https://openalex.org/W4366992486","https://openalex.org/W4385717823","https://openalex.org/W4390754122","https://openalex.org/W4410033669","https://openalex.org/W4410284673","https://openalex.org/W4410483116","https://openalex.org/W4410999680","https://openalex.org/W7163886124"],"related_works":["https://openalex.org/W4410483116","https://openalex.org/W4414882758","https://openalex.org/W4313526154","https://openalex.org/W3175296847","https://openalex.org/W4402725526","https://openalex.org/W7123355232","https://openalex.org/W3214407955","https://openalex.org/W2792493949","https://openalex.org/W2988700104","https://openalex.org/W4401524530"],"abstract_inverted_index":{"Abstract":[0],"Objectives":[1],"Total":[2],"hip":[3],"arthroplasty":[4],"(THA)":[5],"is":[6],"increasingly":[7],"performed":[8],"in":[9,40,182,206,216,230,241,272,282,293],"younger":[10],"men,":[11],"many":[12],"of":[13,22,25,44,55,153,164,189,262],"whom":[14],"regard":[15],"sexual":[16,28,38,53,76],"function":[17,85,213,259],"as":[18,75],"an":[19,279],"important":[20],"component":[21],"postoperative":[23,180,201],"quality":[24,54,188,261],"life.":[26,56,190],"Regular":[27],"activity":[29,39],"contributes":[30],"to":[31,42],"overall":[32,294],"well-being.":[33,295],"Hip":[34],"osteoarthritis":[35],"(OA)":[36],"impairs":[37],"up":[41],"70%":[43],"patients,":[45],"and":[46,51,131,139,157,160,187,203,248,260,274,276],"THA":[47,87,111],"may":[48,277],"restore":[49],"it":[50],"improve":[52],"Although":[57],"the":[58,120,136,148,161,193,196,217,231,235],"direct":[59],"anterior":[60],"approach":[61,122],"(DAA)":[62],"has":[63,88],"been":[64,90],"associated":[65,268,288],"with":[66,192,269,289,298],"faster":[67],"recovery,":[68],"its":[69],"influence":[70],"on":[71],"patient-centred":[72],"outcomes":[73],"such":[74],"health":[77],"remains":[78],"insufficiently":[79],"studied.":[80],"To":[81],"our":[82],"knowledge,":[83],"erectile":[84,283],"after":[86,264],"not":[89],"compared":[91],"between":[92],"surgical":[93],"approaches.":[94],"Methods":[95],"In":[96],"this":[97],"prospective":[98],"multicentre":[99],"cohort":[100],"study,":[101],"87":[102],"sexually":[103],"active":[104],"men":[105],"aged":[106],"18\u201365":[107],"years":[108],"underwent":[109],"primary":[110],"via":[112],"either":[113],"DAA":[114,197,218,266],"(":[115,220,244,251],"n":[116,124],"=":[117,125,246],"49)":[118],"or":[119],"anterolateral":[121],"(ALA;":[123],"38).":[126],"Outcomes":[127],"were":[128,169],"assessed":[129],"preoperatively":[130],"6":[132],"months":[133],"postoperatively":[134],"using":[135,171],"Western":[137],"Ontario":[138],"McMaster":[140],"Universities":[141],"Osteoarthritis":[142],"Index":[143,163],"(WOMAC;":[144],"pain,":[145,183],"stiffness,":[146,184],"function),":[147],"World":[149],"Health":[150],"Organization":[151],"Quality":[152],"Life-BREF":[154],"(WHOQOL-BREF;":[155],"physical":[156,185,242],"psychological":[158,249],"domains),":[159],"International":[162],"Erectile":[165,212],"Function-5":[166],"(IIEF-5).":[167],"Data":[168],"analysed":[170],"two-way":[172],"mixed-design":[173],"ANOVAs.":[174],"Results":[175],"Both":[176,256],"groups":[177],"demonstrated":[178],"significant":[179,226],"improvements":[181,240],"function,":[186,284],"Compared":[191],"ALA":[194,232,236,286],"group,":[195],"group":[198,219,237],"had":[199],"lower":[200],"pain":[202,273],"greater":[204,239,270,290],"reduction":[205],"stiffness":[207,275],"(both":[208],"p":[209,221,245,252],"<":[210,222,253],".001).":[211,254],"improved":[214,258],"significantly":[215],".001),":[223],"whereas":[224,285],"no":[225],"change":[227],"was":[228,267,287],"observed":[229],"group.":[233],"Conversely,":[234],"showed":[238],"well-being":[243,250],".049)":[247],"Conclusions":[255],"approaches":[257],"life":[263],"THA.":[265],"reductions":[271],"confer":[278],"additional":[280],"benefit":[281],"perceived":[291],"gains":[292],"Larger":[296],"studies":[297],"more":[299],"comparable":[300],"cohorts":[301],"are":[302],"warranted.":[303]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-08-31T00:00:00"}