The Direct Anterior Approach (DAA) to the Hip

In a total hip replacement surgery, the function of a damaged and worn-out joint is taken over by an artificial joint, known as a prosthesis. The first step to any joint replacement surgery Is to gain access to the affected joint, and there are a variety of ways this can be done. Over the past decade, the Direct Anterior Approach (DAA) has gained traction as a favored method. It involves accessing the hip joint in a way that safeguards the surrounding muscles from harm.

Smaller incision and reduced tissue damage and early Rehab

The hip is a complex ball and socket joint surrounded by muscles, tendons, and ligaments. Traditional approaches such to the hip joint involves cutting some of these muscles and transecting the tendons that are connected to the hip joint.

8cm Surgical Scar after a DAA Total Hip Replacement Courtesy of Dr Alvin CK Tan

Compared to these approaches, the Direct Anterior Approach uses a smaller 8-15cm incision in the front of the hip. This smaller incision results in less inflammation and damage to the surrounding tissues, which is responsible for a lot of the pain that is experienced by a patient after surgery.

Muscle Sparing DAA Approach Credit: Total Hip Replacement, Springer Link

Crucially, the muscles that surround the hip joint are left intact and not severed. By carefully displacing and retracting these important muscles, the structure and function of the muscles are preserved. This allows for the patient to recover faster and start rehabilitation exercises earlier. This early rehab is important for the patient to regain strength, mobility, and range of motion of the hip.

Improved Stability and Implant Positioning

The muscles and tendons around the hip also contribute to its stability and are crucial in preventing a dislocation of the prosthesis. By keeping these structures intact, there is improved stability of the artificial joint and a reduced risk of dislocation.

In addition, DAA allows the surgeon to use intraoperative X-rays to better visualise the placement of the total hip components, enabling the surgeon to precisely position the hip implant, leading to improved accuracy and alignment. Proper implant positioning is vital for optimal functionality and longevity of the joint replacement.

Reduced Risk of Postoperative Hip Precautions:

Some surgical approaches like the posterior approach require adherence to strict postoperative hip precautions to prevent dislocations. With DAA, there are little to no restrictions on hip movement. This can allow the patient a greater sense of freedom and flexibility during their rehabilitation journey, allowing them to perform daily activities without fear.

The Direct Anterior Approach for hip replacement offers a wide range of benefits that can enhance your journey toward a better hip and improved quality of life. If you’re considering hip replacement, do discuss the Direct Anterior Approach with us. Together, we can explore if this approach is suitable for you, ensuring a successful and more comfortable recovery process that allows you to regain your mobility and enjoy an active lifestyle once again.

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