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Updated: Jan 22, 2026
09:31
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
12.4K
Direct Anterior Total Hip Arthroplasty
Patrick F Bergin1, Anthony S Unger2
1Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216.
JBJS Essential Surgical Techniques
|July 20, 2019
Summary
The direct anterior approach enables minimally invasive total hip arthroplasty through a unique surgical plane. This well-established technique has a long history of successful application in hip replacement surgery.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- The direct anterior approach (DAA) is theoretically ideal for minimally invasive total hip arthroplasty (THA) due to its intermuscular, internervous plane.
- Successful THA via DAA has been documented for decades.
Purpose of the Study:
- To outline the surgical technique for performing total hip arthroplasty using the direct anterior approach.
- To detail critical steps for patient positioning, exposure, and component implantation.
Main Methods:
- Patient positioning and draping on a standard operating table.
- Superficial dissection through the tensor fasciae latae, preserving perforating vessels.
- Deep dissection with the hip flexed at 30°.
- Acetabular preparation with specific anteversion and abduction angles.
- Femoral preparation using offset broaches to avoid greater trochanter perforation.
- Trialing and final closure with checks for impingement.
Main Results:
- The direct anterior approach has been successfully utilized for total hip arthroplasty for many years.
- The described technique allows for THA within a muscle-sparing interval.
Conclusions:
- The direct anterior approach is a viable and time-tested method for performing total hip arthroplasty.
- Meticulous attention to surgical steps, including patient positioning and component placement, is crucial for successful outcomes.
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