Direct Anterior Hip Approach

DIRECT ANTERIOR HIP APPROACH

The Direct Anterior approach for total hip arthroplasty is becoming an increasingly popular technique. Potential benefits to the patient include faster recovery and lack of the need for typical range-of-motion restrictions. Component positioning can potentially be optimized with the aid of intraoperative fluoroscopy, which is facilitated by the supine positioning of the patient.

One of the biggest advantages of the Direct Anterior approach over traditional surgical approaches is the visualization during the surgery. This is because in the Direct Anterior approach, unlike traditional surgical approaches, the incision is made in the front (anterior) of the hip joint between muscles allowing clear access for the procedure.

KEY ASPECTS

Lower dislocation rate than traditional approaches^1-4
- Posterior capsule and external rotators are left intact
- Component placement with visualization
Faster rehabilitation than traditional approaches
- More patients discharged home after surgery^5-7
- Less use of assistive devices after surgery (ex. cane, walker)^7-9
- Less pain medication required^6-8

Direct Anterior Hip Approach APPROCCIO ANTERIORE DIRETTO 540x300 1

REFERENCES

Mirza A. A mini-anterior approach to the hip for total joint replacement: optimizing results – improving hip joint replacement outcomes. Bone Joint J. 2014; 96B(11): 32-5.
Connolly KP, Kamath AF. Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results. World J Orthop. 2016; 7(2):94-101.
Tsukada S, Wakui M. Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results. The Open Orthopaedics Journal. 2015; 9:157-162.
Sheth, D; Cafri, G; Inacio, M; Paxton, EW; Namba, R. Anterior and Anterolateral Approaches for THA Are Associated With Lower Dislocation Risk Without Higher Revision Risk. Clin Orthop Relat Res. 2015; 473:3401–3408.
Alecci V. Comparison of primary total hip replacements performed with a direct anterior versus the standard lateral approach – perioperative finding. J Orthop Traumatol. 2011; 12(3):123-9.
Schweppe M. Does surgical approach in total hip arthroplasty affect rehabilitation, discharge disposition, and readmission rate? Surg Technol Int. 2013; 23:219-27.
Zawadsky M. Early outcome comparison between the direct anterior approach and the mini-incision posterior approach for primary THR - 150 consecutive cases. J Arthroplasty. 2014; 29:1256-1260.
Christensen C. Comparison of patient function during the first six weeks after direct anterior or posterior total hip arthroplasty – a randomized study. J Arthroplasty. 2015; 30(9): 94-7.
Nakata K. A clinical comparative study of the direct anterior with mini-posterior approach – two consecutive series. J Arthroplasty. 2009; 24(5):698-704.