Total hip arthroplasty is a successful surgical procedure performed as a last-line treatment in primary and secondary coxarthrosis.

Recently, the direct anterior approach (DAA) has gained popularity by maintaining abduction force and reducing dislocation rates.

Soft tissue stability in the anterior is increased by adding capsule repair with the preservation of the posterior structures in the DAA.

The degradation of the biological structure of the capsule due to degenerative changes in the end stage coxarthrosis questions the effectiveness of the capsule repair. therefore, the effect of capsule repair on stability is still controversial.

Inclusion Criteria:

• Elective unilateral or bilateral primary total hip arthroplasty
• Direct anterior surgical approach
• 18 years of age or older
• Avascular necrosis of the hip

Exclusion Criteria:

• Rheumatoid arthritis of the hip
• Revision hip arthroplasty
• Younger than 18 years of age
• Crowe type 3 and 4 coxarthrosis