Background: Total hip replacement surgery has proved beneficial in pain relief and functional recovery in patients with end-stage hip disease. However, in recent years, the use of the direct anterior approach has been on the rise due to its muscle-sparing technique and promise of rapid functional recovery. The direct anterior approach makes it possible for surgeons to preserve periarticular musculature, thus promoting rapid mobilization and minimizing complications in the post-op period. Younger patients undergoing total hip replacement surgery feel the need for rapid recovery of strength and function in order to attend their occupational requirements effectively. Physiotherapy has an important role in functional recovery with pain control, recovery of movements, strengthening, and gait training. There is a lack of literature regarding combined orthopedic and physiotherapeutic results in young patients undergoing direct anterior approach total hip replacement surgery.

Aim: To evaluate clinical and functional outcomes following direct anterior approach total hip replacement with structured physiotherapy rehabilitation in a young adult.

Case Presentation: A 35-year-old male patient complained of left hip pain and inability to walk for six months after a fall. His NPRS score for pain was 4/10 on rest, 9/10 on ambulation, and 8/10 on functional activity. As he did not respond well to conservative management, the patient underwent left total hip replacement using the direct anterior approach. On post-operative analysis, the patient experienced mild pain in the surgical site, difficulty in ambulating, and lack of confidence in weight-bearing on the left lower limb. On examination, there was an antalgic gait, limited and painful movements of the left hip, and decreased muscle strength (MMT 3/5) compared to the opposite limb, which had muscle strength of 5/5.

Intervention: The post-operative physiotherapy plans included strength training, mobility exercises, gait re-education, and functional training exercises tailored to the patient's needs.

Outcome Measures: The patient was assessed using an array of outcome measures which included: NPRS, Harris Hip Score, Oxford Hip Score, timed up and go test, 30 sec Chair Stand test, (HOOS) Hip Disability and Osteoarthritis Outcome Score, POMA, LEFS, Six-min Walk test, Hip Abductors Endurance test, 30 sec Chair Stand test and Timed up and go test.

Results: The patient demonstrated significant improvement on all outcome measures with reductions in pain and improved levels of mobility and independence when engaged in daily activities.