The popularity of direct anterior approach for hip replacement surgery is increasing as evidenced by the number of courses offered by orthopedic manufacturers and articles published in orthopedic journals. We recently had our article comparing direct anterior approach total hip to mini-posterior approach total hip accepted for publication in The Journal of Arthroplasty. Based on our study, we have found that patients have less postoperative pain, recover more quickly, and are able to return to activity without restriction sooner using the direct anterior approach. When controlling for other variables, the different surgical approach seems to be the variable that is most significant in the above mentioned items. The anterior approach also allows interoperative adjustment of implant positioning, leading to more accurate placement of the socket and stem in hip replacement. This hopefully will have a positive long-term benefit decreasing wear of the implants due to proper mating of the bearing surfaces. We will continue to follow our patients in the above mentioned study out to 5 years to ensure that mid term followup reinforces the early positive results of the direct anterior approach.
—William P. Barrett, MD