Direct Anterior Approach

Meet Dr. Steven Louis

Dr. Louis is one of the few orthopedic surgeons in Illinois replacing hips from a direct anterior approach.  He has now performed over 1,200 procedures in the past six years.  This Direct Anterior Approach is one of the newest minimally-invasive techniques used in hip replacement surgery. Most orthopedic surgeons use the traditional posterior approach.  Expanding on the pelvic trauma reconstruction work that Dr. Louis does, this Direct Anterior Approach to hip surgery is one that he uses exclusively in hip replacement surgery and has significant benefits to the patient.

The Direct Anterior Approach for total hip replacement is a tissue-sparing alternative to traditional hip replacement surgery that provides the potential for less pain, faster recovery and improved mobility because the muscle tissues are spared during the surgical procedure. The technique allows the surgeon to work between muscles and tissues without detaching them from either the hip or thighbones – avoiding trauma to the tissues.

Compared to traditional hip replacement, which involves an 8 to 12-inch incision from the side or back, the direct anterior total hip replacement is a front (anterior) approach with a smaller incision, three to four inches long.  When Dr. Louis performs this type of surgery, it is not necessary for him to cut any muscles or tendons around the hip.  This means that patients have more freedom of movement after surgery and leg lengths are equal at the end of surgery.  Also, dislocation rates are lower and recovery is faster and less painful.

Dr. Louis of Hinsdale Orthopaedics uses a highly specialized operating table allowing X-rays to be obtained during the surgery.  This ensures precise placement of the implants, resulting in more functional hip mechanics and equal leg lengths.

Benefits of Direct Anterior for the Patient

  • Reduced tissue trauma
  • Less pain, meaning less pain medication
  • Faster recovery
  • Little or no physical rehabilitation
  • Earlier release from hospital
  • No restriction of post-op activity
  • More accurate leg lengths and alignment with intra-operative X-ray
  • Preservation of the hip musculature
  • No hip precautions after surgery
  • Decreased risk of post-op dislocation
  • Minimal scarring
  • Patients may walk same day as surgery
  • Replacement is easier for patients who are overweight or obese.
  • Cost-effective because shorter hospital days

Direct Anterior Approach Requires Skilled Surgeon

The success of the surgery depends on several factors, but the most important factor is having a highly-trained and experienced surgeon, like Dr. Louis, who now even trains other surgeons on this procedure.  The surgical approach, the implant and the patient’s health and commitment to post-operative physical therapy also play an important role in recovery.   The direct anterior approach may make sense for almost all patients, however, it may not be the best choice for a select few.  Patients should talk with their doctor if they have questions about the direct anterior approach for total hip replacement.