Blom AW, Hunt LP, Matharu GS, et al. - An analysis of 723,904 elective operations from the national joint registry for England, wales, northern Ireland, and the isle of man was designed to investigate the impact of surgical approach in total hip replacement on outcomes. Researchers examined a sum of 723,904 primary THRs captured in the National Joint Registry, linked to hospital inpatient, mortality, and patient-reported outcome measures (PROMs) data with up to 13.75 years follow-up. The revision rates and 90-day mortality were compared using survival methods. The Cox proportional hazards and Flexible Parametric Survival Modelling (FPM) were applied to compare groups. In comparison with the posterior approach, lateral approaches for THR are correlated with worse outcomes, including more deaths and revisions. It was recommended that, for THR, the posterior approach should be considered the current standard approach. Future studies are needed to evaluate any potential benefits from applying minimally invasive posterior approaches and the conventional anterior approach.