Understanding The Direct Anterior Approach for Hip Replacement

The Direct Anterior Approach is one of today’s most minimally invasive techniques used in total hip replacement surgery. It is known as a relatively bloodless, direct, muscle-sparing approach that enables us to easily access the hip while at the same time provides excellent visualization of the patient’s hip socket. This is in sharp contrast to traditional hip replacement techniques that involve operating from the side (lateral) or the back (posterior) of the hip, and require a significant disturbance of the joint and connecting tissues during the surgery as well as an approximately 8-12 inches long incision at the surgical site.

The three approaches to hip replacement.

In comparison, the direct anterior approach allows the incision to be about 3-4 inches in length and located at the front of the hip. In this position, your POA surgeon does not need to detach any of the muscles or tendons. Instead, this approach allows us to pull the patients primary muscles to the side, rather than cutting them to gain access to the hip joint.

In addition, rehabilitation after having a direct anterior approach hip replacement is often accelerated, because we are able to replace our patient’s hip joint without the detachment of muscle from their pelvis or femur. During this procedure the gluteal muscles and other natural stabilizers are left undisturbed, often making it possible for our patients to regain their mobility fairly quickly. In fact, the normal post-operative restriction of limiting hip movement to 90 degrees does not apply to our patients who have undergone the direct anterior approach. Following the procedure, our patients may bend their hip freely, allowing them to return to their normal daily activities like sitting, walking up and down stairs, or getting into or out of a car with only minimal restriction.

The Potential Benefits of the Direct Anterior Hip Replacement

  • Decreased hospital stay and quicker rehabilitation
  • The potential for smaller incision and reduced muscle disruption may allow patients a shorter recovery time and less scarring
  • The potential for less blood loss, less time in surgery, and reduced post-operative pain
  • Patients may have a decreased risk of hip dislocation after surgery due to the minimally invasive nature of this procedure
  • May allow for a more natural return to normal function and activity compared to the posterior lateral approach