The Direct Anterior Approach

Are all Total Hip Replacement Surgeries the same?  No!

The greatest advancement in Total Hip Replacement in recent years is The Direct Anterior Approach (DAA). An approach is the “route” a surgeon takes from skin incision to the hip joint while performing the procedure. Traditional approaches include the posterior, lateral, or anterolateral approach. These approaches require cutting muscles and tendons during the surgery. Cutting muscles and tendons increases pain after surgery and requires special precautions in the postoperative period to protect their repair. Traditional hip replacements are done with the patient lying on their side, making it harder to match leg lengths that can cause limping. I use the Direct Anterior Approach.

The Direct Anterior Approach provides my patients four main advantages: No Cutting Muscles and Tendons, improved implant positioning, no postoperative precautions, and reduced pain postoperatively. Approaching the hip between muscles instead of cutting muscles and tendons provides less pain after surgery and my patients walk normally (often without a cane or walker) very soon after surgery. My patients have no restrictions unlike those operated with traditional approaches: my patients can squat, cross their legs, and sleep on their sides.

Improved implant positioning provided by the Anterior Approach results in a hip dislocation risk of 1%, three to six times less than the dislocation risk using traditional approaches. Leg length discrepancy is much less common because X-ray is used during the surgery. Changes can be made intraoperatively to improve accuracy. Limping due to length differences is almost nonexistent.

Hip precautions and restrictions on patients, lasting months, are necessary after traditional replacements. My Direct Approach patients have no restrictions after surgery.

I adopted the Direct Anterior Approach for hip replacement 5 years ago because it is a better way. Patients have less pain and walk faster without a cane or walker because no muscles are cut. Implants are positioned for optimal function. Most importantly, patient satisfaction is higher using the Anterior Approach.

4 Main Advantages of the Direct Anterior Approach:

1. No cutting muscles or tendons
2. Improved implant Positioning
3. Less pain after surgery
4. Improved patient satisfaction after surgery

Louisiana Orthopaedic Specialists is a comprehensive musculoskeletal orthopaedic practice, comprised of 13 fellowship-trained orthopaedic surgeons. If you or someone you know is suffering from hip pains or could be a candidate for the direct anterior approach, please contact us to request an appointment.

Blog by Adam T. Perry, MD