AgingResearch.NewsJoin free

Direct anterior approach

Direct anterior approach has been studied in 5 papers since 2021: 1 trial and 4 observational studies in people; 2 in the past year. The newest story, Nov 11, 2026: “Hip surgery from the front not linked to fewer deaths”.

Exposure

5 papers study it14 findingsUpdated

1 new paper in 30 daysSee all 5 papers on direct anterior approach

At a glance

The findings reach people, from one lab or study. 5 independent labs in 4 countries.

“There was no statistically significant difference in TUG times at 6 weeks postoperatively between the DAA and the DLA”
Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trialActa orthopaedica2025doi:10.2340/17453674.2025.42847

1 of its findings points the other way.

Humans: a single group. Cells, worms or flies and mice: nothing yet.

C, W, M, H: cells, worms or flies, mice, humans. Dark: independent labs found the same change there. Light: one lab or one study. Outline: nothing yet.

Labs are independent when their papers share no last author and no institution.

Against: findings that point the other way from most findings on the same outcome.

  • 5 independent labs in 4 countries
  • 1 finding against
  • Human trial1
  • Humans4

What did studies of direct anterior approach find?

11

Studies of direct anterior approach measured 11 outcomes, among them mortality, forgotten Joint score and timed Up and Go.

Mortality

downin humans1no changein humans1

2 studies

  1. Direct anterior approach is linked with lower mortality in humans (26.5% vs. 17.7%, p = 0.005).

    “1 year (26.5% vs. 17.7%, p = 0.005) were significantly higher in the SLA group.”

    Humans1 year

    Transition from Straight Lateral to Direct Anterior Approach in Hip Hemiarthroplasty: Preservation of Independent Living and Lower 1-Year Mortality

    Journal of clinical medicine

  2. Direct anterior approach was not clearly linked with mortality in humans following hemiarthroplasty for femoral neck fracture (30-days: 7.6 vs 5.7%).

    “Blood loss (286 vs 287 ml), LOS (10.4 vs 9.5 days), pain (cessation of opioid medication: 2.9 vs 3.3 days post-op), revision (2.5 vs 3.2%) or mortality (30-days: 7.6 vs 5.7%) did not differ between patient groups.”

    Humansfollowing hemiarthroplasty for femoral neck fracturen = 237

    Direct anterior approach improves in-hospital mobility following hemiarthroplasty for femoral neck fracture treatment

    Archives of orthopaedic and trauma surgery

Forgotten Joint score

upin humans1

1 study

  1. Direct anterior approach improves forgotten Joint score in humans (estimated mean difference 15 (CI 5–25)).

    “The FJS score was significantly higher for the DAA group at 2, 6, and 12 weeks postoperatively.”

    Human trial52 weeksn = 130

    Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial

    Acta orthopaedica

  2. Direct anterior approach improves forgotten Joint score in humans (displaced femoral neck fractures).

    “patients who underwent DAA had a significantly higher FJS at 2, 6, and 12 weeks”

    Human trialdisplaced femoral neck fractures12 weeksn = 130

    Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial

    Acta orthopaedica

Timed Up and Go

no changein humans1

1 study

  1. Direct anterior approach showed no clear effect on timed Up and Go in humans (estimated mean difference –1.8 s (CI –5.7 to 2.0)).

    “There was no statistically significant difference in TUG times at 6 weeks postoperatively between the DAA and the DLA, 16.0 s (CI 13.2–18.7) vs 17.8 s (CI 15.1–20.4), estimated mean difference –1.8 s (CI –5.7 to 2.0).”

    Human trial52 weeksn = 130

    Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial

    Acta orthopaedica

  2. Direct anterior approach showed no clear effect on timed Up and Go in humans (displaced femoral neck fractures) (-1.8 s (CI -5.7 to 2.0)).

    “There was no statistically significant difference in TUG times at 6 weeks postoperatively between the DAA and the DLA”

    Human trialdisplaced femoral neck fractures6 weeksn = 130

    Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial

    Acta orthopaedica

1-year mortality

no changein humans1

1 study

  1. Direct anterior approach was not clearly linked with 1-year mortality in humans (1-year mortality: 26% (DAA), 26% (PLA), 26% (SLA), and 27% (ALA)).

    “This study found no significant differences in 1-year mortality between the DAA and conventional surgical approaches for HHA in elderly patients with hip fractures.”

    HumansHip fracture treated with hemiarthroplasty; compared with conventional surgical approaches after propensity score matching1 yearn = 21,393

    Hip surgery from the front not linked to fewer deaths

    Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology

Activities of daily living

upin humans1

1 study

  1. Direct anterior approach is linked with better activities of daily living in humans (ΔKatz ADL -0.11 ± 1.60 vs. -0.73 ± 1.57, p = 0.036).

    “The decline in Katz ADL score at three months was significantly greater in the SLA group than in the DAA group (ΔKatz ADL -0.73 ± 1.57 vs. -0.11 ± 1.60, p = 0.036).”

    Humans3 months

    Transition from Straight Lateral to Direct Anterior Approach in Hip Hemiarthroplasty: Preservation of Independent Living and Lower 1-Year Mortality

    Journal of clinical medicine

Independent living

upin humans1

1 study

  1. Direct anterior approach is linked with better independent living in humans (41.4% vs. 23.2%, p < 0.001).

    “Among patients living at home preoperatively, return-to-home after surgery was lower for SLA compared to DAA (23.2% vs. 41.4%, p < 0.001).”

    Humanspostoperative

    Transition from Straight Lateral to Direct Anterior Approach in Hip Hemiarthroplasty: Preservation of Independent Living and Lower 1-Year Mortality

    Journal of clinical medicine

Oxford Hip Score

upin humans1

1 study

  1. Direct anterior approach improves oxford Hip Score in humans (estimated mean difference 4 (CI 1.2–7.3)).

    “The OHS score was higher for the DAA group at week 6, 35 (CI 33–38) vs 31 (CI 29–33), estimated mean difference 4 (CI 1.2–7.3).”

    Human trial52 weeksn = 130

    Direct anterior and direct lateral approach in patients with femoral neck fractures receiving a total hip arthroplasty: a randomized controlled trial

    Acta orthopaedica

Complication rate

no changein humans1

1 study

  1. Direct anterior approach was not clearly linked with complication rate in humans (medial femoral neck fractures) (6% vs 8%, p = 0.61).

    “Similar hospital stays (7 vs 7 days; p = 0.55) and complication rates (6% vs 8%; p = 0.61) were observed among groups”

    Humansmedial femoral neck fracturesn = 162

    Outcomes of direct anterior approach for uncemented total hip replacement in medial femoral neck fractures: a retrospective comparative study on the first 100 consecutive patients

    BMC musculoskeletal disorders

Ability to climb stairs

upin humans1

1 study

  1. Direct anterior approach is linked with better ability to climb stairs in humans (medial femoral neck fractures) (37% vs 21%, p = 0.041).

    “faster postoperative functional recovery witnessed by the ability to climb stairs at hospital discharge (37% vs 21%; p = 0.041).”

    Humansmedial femoral neck fracturesn = 162

    Outcomes of direct anterior approach for uncemented total hip replacement in medial femoral neck fractures: a retrospective comparative study on the first 100 consecutive patients

    BMC musculoskeletal disorders

Duration of surgery

downin humans1

1 study

  1. Direct anterior approach is linked with lower duration of surgery in humans following hemiarthroplasty for femoral neck fracture (72.5 vs 89.5 min, p < 0.001).

    “had shorter surgeries (DAA vs ALA: 72.5 vs 89.5 min, p < 0.001)”

    Humansfollowing hemiarthroplasty for femoral neck fracturen = 237

    Direct anterior approach improves in-hospital mobility following hemiarthroplasty for femoral neck fracture treatment

    Archives of orthopaedic and trauma surgery

All 11

What is direct anterior approach linked with?

1

Studies link direct anterior approach with prosthesis-related infection.

Prosthesis-related infection

upin humans1

1 study

  1. Direct anterior approach is linked with a higher risk of prosthesis-related infection in humans (4.6% vs. 1.5%, p = 0.024).

    “SLA had significantly lower rates of periprosthetic joint infections (SLA n = 6 (1.5%) vs. DAA n = 15 (4.6%), p = 0.024).”

    Humans

    Transition from Straight Lateral to Direct Anterior Approach in Hip Hemiarthroplasty: Preservation of Independent Living and Lower 1-Year Mortality

    Journal of clinical medicine

More on Prosthesis-related infection

Latest

Dec 2025: 0Jan 2026: 0Feb 2026: 1Mar 2026: 0Apr 2026: 0May 2026: 0Jun 2026: 0Jul 2026: 0Aug 2026: 1Sep 2026: 0Oct 2026: 0Nov 2026: 02 papers in 12 months
Journal of Orthopaedics and Traumatology

Hip surgery from the front not linked to fewer deaths

One-year death rates were 26% with surgery from the front, versus 26%, 26% and 27% with three other approaches.One-year death rates were 26% with surgery from the front, versus 26%, 26% and 27% with three other approaches.

Cohort · 21,393 peopleInterventions
Paper

Related