Total hip replacement: the direct superior approach (DSA)

Written by: Mr Constant Busch
Edited by: Laura Burgess

In order for a patient to undergo a total hip replacement, it is inevitable that a surgical approach to the hip has to be made. There are a number of approaches available. Each one has its advantages and its disadvantages. A relatively novel approach is called the direct superior approach or DSA.

What are the traditional hip replacement procedures?

The most common traditionally-used approaches are the lateral or direct lateral approach, the posterior approach, which is the most commonly used in the United Kingdom, and the anterior approach.

How does DSA differ from these traditional procedures?

The direct superior approach is a type of posterior approach. The difference is that with the DSA the majority of the procedure is done through a muscle splitting approach and only two tendons have to be divided in order to obtain access to the hip.

How does DSA differ from these traditional procedures?

Splitting muscles is always preferred over cutting muscles as muscle damaged by cutting takes longer to heal and may be more uncomfortable. The two tendons can easily be repaired and reduce the amount of trauma, allowing access to the hip joint to a great extent.

What are the benefits of DSA?

Performing a total hip replacement by minimising trauma to the soft tissue has considerable benefits with regards the speed of recovery. There is evidence to suggest that patients undergoing total hip replacement using a direct superior approach recover more quickly. That is one of the main benefits of DSA.

Who is eligible for DSA surgery?

Most patients can undergo total hip replacement using the DSA approach. Like any other approach, however, patients who are very muscular or considerably overweight may not be ideal candidates for a direct superior approach. Patients wishing to undergo total hip replacement using DSA should be assessed on their individual merits and requirements.


If you are considering hip surgery, book now for a consultation with one of our specialists

By Mr Constant Busch
Orthopaedic surgery

Mr Constant Busch is a leading orthopaedic surgeon, specialising in primary hip and knee replacement surgery. His sub-specialty includes hip problems in young people, and revision hip and knee replacement surgery. Originally from the Netherlands,

Mr Constant Busch has studied and gained experience at the Duke University, USA, Ontario, Canada, and in London, UK. Mr Busch performs over 500 surgical procedures per year, and is known for his personalised treatment of patients, and the use of the latest in implant technology, and rehabilitation processes. He discusses procedure options in depth with patients, ensuring they understand and are in agreement with the proposed treatment. These include non-operative management as well as range of current surgical treatment. Alongside his clinical practice,

Mr Busch has also contributed to numerous peer-reviewed publications in medical journals, along with reviewing articles related with joint replacement for the British Journal of Bone and Joint Surgery.

View Profile

Overall assessment of their patients

We use cookies on this site to enhance your user experience. Click ‘Enter’ to continue browsing. Enter Cookies policy