The Direct Anterior Approach: A Comprehensive Guide for the Learner and Educator

Total hip arthroplasty is one of the most widely performed procedures demonstrating excellent clinical outcomes and implant longevity. Enhanced imaging modalities, advancements in material science, and improvements in surgical technique have contributed to the global success of this procedure. One such technique has gained significant attention over the past decade – the direct anterior approach (DAA). First described by Carl Hueter in 1881, the DAA is now more commonly credited to Smith-Peterson. This technique demonstrates rapid recovery, reduced hospital length of stay, and enhanced stability. Despite these advantages, there is a well reported learning curve for surgeons, particularly for those who trained using an alternative surgical approach. In this chapter we explore a methodological approach to mitigate and decrease the learning curve; allowing for a safe and reproducible guide to teach surgeons how to transition to the DAA