The direct anterior approach (DAA) to the hip was initially described in the 19th century and has been used sporadically for total hip arthroplasty (THA). In the past decade, enthusiasm for the approach has been renewed because of increased demand for minimally invasive techniques. New surgical instruments and tables designed specifically for use with the DAA for THA have made the approach more accessible to surgeons. Some authors claim that this approach results in less muscle damage and pain as well as rapid recovery, although limited data exist to support these claims. The DAA may be comparable to other THA approaches, but there is no evidence to date that shows improved long-term outcomes for patients. The steep learning curve and complications unique to this approach (fractures and nerve damage) have been well described. However, the incidence of these complications decreases with greater surgeon experience. A question of keen interest to hip surgeons and patients is whether the DAA results in improved early outcomes and long-term results comparable to those of other approaches for THA.
From the Rothman Institute, Thomas Jefferson University, Egg Harbor Township, NJ.
Dr. Post or an immediate family member has received research or institutional support from DePuy and serves as a paid consultant to Smith & Nephew and Johnson & Johnson. Dr. Orozco or an immediate family member serves as a paid consultant to Stryker and Medtronic and has received research or institutional support from Zimmer and Stryker. Dr. Hozack or an immediate family member has received royalties from, serves as a paid consultant to, and has received research or institutional support from Stryker and serves as a board member, owner, officer, or committee member of The Hip Society. Dr. Ong or an immediate family member serves as a paid consultant to Stryker, Smith & Nephew, and Medtronic. Neither Dr. Diaz-Ledezma nor any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.