Direct Anterior Approach (DAA)

Direct Anterior Approach to Total Hip Replacement

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Minimally Invasive Surgery (MIS) Hip Joint Replacement is an advancement in hip replacement that offers important advantages over standard surgical procedures. Stryker has partnered with surgeons worldwide to develop MIS procedures and surgical instruments that are designed to help your surgeons do their very best to help you recover your lifestyle. These techniques bring together a wide variety of hip implants, new minimally invasive surgical techniques, and new instrumentation.

The direct anterior approach is one of the minimally invasive techniques used in hip replacement surgery. Continuing orthopaedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip replacement.1

Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. In comparison, the direct anterior approach requires an incision that is only 3-4 inches in length and located at the front of the hip.1 In this position, the surgeon does not need to detach any of the muscles or tendons.1

Discuss Your Options With Your Physician

Hip replacement, no matter how minimally invasive, is major surgery and patients are at risk for complications. However, the complication rate following joint replacement surgery is generally very low. Serious complications, such as joint infection, occur in less than 2% of patients.6 Besides infection, possible complications include blood clots, lung congestion or pneumonia. The risks that are normally encountered in conventional hip joint replacement remain. Recovery success depends on several factors including surgeon training and experience, the surgical approach, the implant and the patient’s health and commitment to post-operative physical therapy. Although the direct anterior approach may make sense for some patients, only your surgeon can help you decide what is best for you. Talk with your doctor if you have any questions about the direct anterior approach for total hip replacement or hip replacement in general.

Find a surgeon in your area utilizing the Direct Anterior Approach.

DAA Surgical Considerations, Precautions and Potential Benefits

Real Patients
Real Stories

Watch direct anterior approach testimonials and learn the benefits of this approach.

Lorre Haschke – DAA Patient
Watch Lorre's Testimonial

Ron Ivy – DAA Patient
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Read other stories featuring hip replacement recipients.

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Surgical Considerations:
Traditional vs. Direct Anterior Approach

Traditional Hip Replacement

Direct Anterior Approach

  • 8-12 inch incision
  • Surgical approach - side (lateral) or back (posterior)
  • Disturbance of the joint and connecting tissues
  • 3-4 inch incision
  • Surgical approach - front (anterior)1
  • Muscles or tendons not detached1

Typical Precautions: Traditional vs. Direct Anterior

Traditional Hip Replacement

Direct Anterior Approach

  • Do not cross legs5
  • Do not bend hip more than a right angle5
  • Do not turn feet excessively inward or outward5
  • Use a pillow between your legs when sleeping5
  • Under doctor's supervision, may be immediately allowed to move their hips
  • May potentially avoid restrictions associated with traditional hip replacement2

Potential Benefits of Direct Anterior

1. Wenz, J., Gurkan, I. Jibodh, S., “Mini-Incision Total Hip Arthroplasty: A Comparative Assessment of Perioperative Outcomes,” Orthopedics Magazine, 2002.
2., Kreuzer, S.
3. Keggi, Kristaps I., “Total Hip Arthroplasty Through a Minimally Invasive Anterior Surgical Approach,” JBJS, Vol. 85-A. 2003.
4. Baerga-Varela, L., Malanga, G.A., “Rehabilitation after Minimally Invasive Surgery.” Hozack, W., Krismer, M., Nogler, M., Bonutti, P., Rachbauer, F., Schaffer, J., Donnelly, W., ed. Minimally Invasive Total Joint Arthroplasty. New York, NY: Springer-Verlag; 2004: 2-5.
5. AAOS website,, accessed Nov. 2008.
6. Hanssen, A.D., et al., “Evaluation and Treatment of Infection at the Site of Total Hip or Knee Arthroplasty,” JBJS, pp. 910-922.