Daniel C. Allison, MD

The direct anterior, or the anterior supine intermuscular, approach for total hip arthroplasty continues to gain acceptance with surgeons as patient demand for the procedure remains high. Many studies have demonstrated advantages with the approach, including improved gait symmetry at 6 weeks postoperatively, decreased dislocation rate, decreased muscle damage, decreased pain and more accurate leg-length restoration when compared with the posterior approach. The reduced hospital stay and earlier return to activities, such as driving, work, and recreation, afforded by the approach is appealing to both middle-age and elderly patients. In experienced hands, the anterior approach total hip arthroplasty is a safe and effective procedure. However, the approach does carry a lengthy learning curve and may result in an increased complication rate during the learning period.