What Is the Direct Anterior Approach?

The Direct Anterior Approach (DAA) is a surgical technique for total hip replacement in which the hip is accessed through a natural interval between muscles at the front of the hip, without cutting through any muscles. Traditional posterior or lateral approaches require detaching muscle from the femur, which must then be reattached and healed before full function is restored.

Advantages of the DAA

  • Muscle preservation — no muscles are cut, reducing post-operative pain and accelerating recovery
  • Lower dislocation risk — particularly important in the early recovery period
  • Earlier weight-bearing — most patients walk with minimal assistance within 24 hours
  • No movement restrictions — patients can cross their legs and bend freely from day one
  • Faster return to driving and activities
  • Cosmetic scar — anterior thigh incision is less visible than posterior buttock scars

Use of Fluoroscopy and Robotics

The DAA allows real-time X-ray (fluoroscopy) and robotic guidance (Mako™) to verify component position during surgery. Dr Liew uses intraoperative fluoroscopy routinely to optimise implant positioning and reduce the risk of leg length discrepancy, while Dr Mooney uses Mako™ robotic-arm assistance to guide precise component placement.

Is DAA Right for Everyone?

The DAA is suitable for the majority of patients requiring total hip replacement. Very obese patients or those with complex anatomy may be better served by alternative approaches. your surgeon will discuss the most appropriate technique for you during your consultation.

Recovery Compared to Other Approaches

Patients typically use crutches for 2–4 weeks (vs. 4–8 weeks with traditional approaches), return to driving at 4–6 weeks, and resume full activities at 3–4 months. Physiotherapy is still important to optimise strength and function, though the rehabilitation program is generally shorter.