Memorial Bone & Joint Research Foundation
Memorial Bone & Joint Research Foundation
 

Direct Anterior Approach DAA Hip Resurfacing

The direct anterior approach for total hip resurfacing is one of the minimally invasive techniques used in hip resurfacing surgery. Continuing orthopedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip resurfacing. Traditional hip resurfacing 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 hip resurfacing requires an incision that is only 5-6 inches in length and located at the front of the hip. In this position, the surgeon does not need to detach any of the muscles or tendons. This may allow for a more natural return to normal function and activity. The smaller incision and reduced disruption indicate that patients may also have a shorter recovery time and less scaring. With this approach and the minimization of the tissue damage, there may also be less blood loss, less time in surgery and reduced post-operative pain. Some physicians use a special operating room table to help achieve an optimized surgical position for the patient.

The hip resurfacing provides an alternative to primary total hip arthroplasty for younger and more active patients having osteoarthritis of the hip joint. The potential advantage of hip resurfacing include less bone removal (bone preservation), a potentially less chances of hip dislocations due to a relatively larger femoral head size, and possible easier revision surgery for a subsequent total hip replacement device because a surgeon could have more bone stock available to work with. Patient suitability for hip resurfacing is decided by the patient's anatomy and the doctor. Hip resurfacing is intended for younger patients, who are not morbidly obese, are clinically qualified for a hip replacement, have been diagnosed with non inflammatory degenerative joint disease, do not have an infection, and are not allergic to the metals used in the implant. Hip resurfacing should not be used on patients who have severe bone loss in their femoral head, those with large femoral neck cysts present (typically found at surgery), or patients who have poor bone stock in the acetabulum. During the procedure, the surgeon will only remove a few centimeters of bone around the femoral head, shaping it to fit tightly inside the femoral head implant. The surgeon will also prepare the acetabulum for the metal cup that will form the socket joint. While the resurfacing component slides over the top of the femoral head like a tooth cap, the acetabular component is pressed into place much like a total hip replacement would be.

 

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