create ppt slides Slide 1 — Title Rising Utilization of the Direct Anterior Approach in Total Hip Arthroplasty A review of registry, board-certification, and surgeon-survey data Slide 2 — Key Message The direct anterior approach (DAA) has risen sharply and now exceeds 50% of primary THA among U.S. surgeons. It has supplanted the posterior and lateral approaches as the most common technique — especially among early-career surgeons. The trend appears across registry data, board-certification data, and surgeon surveys. (Driesman and Yang, Arthroplasty, 2023; Nelson et al., J Arthroplasty, 2025) Slide 3 — Population & Market-Level Trends U.S.: Anterior-approach THA grew from an estimated 12% (2009) to 40% (2018), and most recent AAHKS polling places the DAA at >50% of primary THA. Ontario, Canada (population-based): Anterior approach rose from 8% (2015) to 12% (2017). Over 2015–2019 (30,098 THAs): 10% anterior, 70% lateral, 20% posterior — a lower baseline and slower adoption than the U.S. (Pincus et al., JAMA, 2020; Driesman and Yang, Arthroplasty, 2023) Slide 4 — Generational Shift: ABOS Board Data Among 35,068 THAs submitted to the American Board of Orthopaedic Surgery, 2022–2023: Approach Early-Career (Part II) Experienced (Recert) Direct anterior 69% 43% Posterior 26% 43% Direct lateral 2% 6% Other 2% 7% Early-career surgeons adopt the DAA at a markedly higher rate. (Nelson et al., J Arthroplasty, 2025) Slide 5 — Surgeon-Survey Data 2019 AAHKS survey (996 respondents): 56.2% currently perform the DAA; 76.1% of performers report increased patient market share. DAA performers had been in practice fewer years than non-performers (17.0 vs 20.9 years). Hip Society survey (high-volume academics): only 49.3% had ever used the DAA; 42.9% of former users abandoned it; only 22.5% believed evidence proves benefits outweigh risks. (Patel et al., J Arthroplasty, 2019; Woolson, Bone Joint J, 2020) Slide 6 — Caveats & Trade-offs Growth driven substantially by surgeon promotion and marketing, not high-level comparative evidence. Benefits: faster early rehabilitation, less muscle damage, lower dislocation rates. Trade-offs: Australian registry (122,345 THAs): higher early major revisions and femoral complications (periprosthetic fracture, femoral loosening). Ontario: higher 1-year major complication rate (2% vs 1%). Long-term RCT evidence of superiority remains limited. (Hallstrom and Hughes, JAMA, 2020; Hoskins et al., JBJS Am, 2020; Pincus et al., JAMA, 2020; Woolson, Bone Joint J, 2020) Slide 7 — Summary DAA utilization is rising rapidly and is now the dominant approach in the U.S., led by early-career surgeons. The shift is generational and partly market-driven. Clinical benefits are real but accompanied by early femoral complication and revision trade-offs; durable comparative evidence is still maturing.
create ppt slides
Slide 1 — Title
Rising Utilization of the Direct Anterior Approach in Total Hip Arthroplasty
A review of registry, board-certification, and surgeon-survey data
Slide 2 — Key Message
The direct anterior approach (DAA) has risen sharply and now exceeds 50% of primary THA among U.S. surgeons.
It has supplanted the posterior and lateral approaches as the most common technique — especially among early-career surgeons.
The trend appears across registry data, board-certification data, and surgeon surveys.
(Driesman and Yang, Arthroplasty, 2023; Nelson et al., J Arthroplasty, 2025)
Slide 3 — Population & Market-Level Trends
U.S.: Anterior-approach THA grew from an estimated 12% (2009) to 40% (2018), and most recent AAHKS polling places the DAA at >50% of primary THA.
Ontario, Canada (population-based): Anterior approach rose from 8% (2015) to 12% (2017).
Over 2015–2019 (30,098 THAs): 10% anterior, 70% lateral, 20% posterior — a lower baseline and slower adoption than the U.S.
(Pincus et al., JAMA, 2020; Driesman and Yang, Arthroplasty, 2023)
Slide 4 — Generational Shift: ABOS Board Data
Among 35,068 THAs submitted to the American Board of Orthopaedic Surgery, 2022–2023:
Approach Early-Career (Part II) Experienced (Recert)
Direct anterior 69% 43%
Posterior 26% 43%
Direct lateral 2% 6%
Other 2% 7%
Early-career surgeons adopt the DAA at a markedly higher rate.
(Nelson et al., J Arthroplasty, 2025)
Slide 5 — Surgeon-Survey Data
2019 AAHKS survey (996 respondents): 56.2% currently perform the DAA; 76.1% of performers report increased patient market share.
DAA performers had been in practice fewer years than non-performers (17.0 vs 20.9 years).
Hip Society survey (high-volume academics): only 49.3% had ever used the DAA; 42.9% of former users abandoned it; only 22.5% believed evidence proves benefits outweigh risks.
(Patel et al., J Arthroplasty, 2019; Woolson, Bone Joint J, 2020)
Slide 6 — Caveats & Trade-offs
Growth driven substantially by surgeon promotion and marketing, not high-level comparative evidence.
Benefits: faster early rehabilitation, less muscle damage, lower dislocation rates.
Trade-offs:
Australian registry (122,345 THAs): higher early major revisions and femoral complications (periprosthetic fracture, femoral loosening).
Ontario: higher 1-year major complication rate (2% vs 1%).
Long-term RCT evidence of superiority remains limited.
(Hallstrom and Hughes, JAMA, 2020; Hoskins et al., JBJS Am, 2020; Pincus et al., JAMA, 2020; Woolson, Bone Joint J, 2020)
Slide 7 — Summary
DAA utilization is rising rapidly and is now the dominant approach in the U.S., led by early-career surgeons.
The shift is generational and partly market-driven.
Clinical benefits are real but accompanied by early femoral complication and revision trade-offs; durable comparative evidence is still maturing.
Created using ChatSlide
The landscape of Total Hip Arthroplasty (THA) is evolving with the rise of Direct Anterior Approach (DAA), which has seen U.S. adoption soar from 12% to over 50%, though Ontario lags behind. Early-career surgeons are more inclined to adopt DAA compared to their experienced counterparts, influenced by market dynamics. While DAA offers benefits like quicker recovery and reduced dislocations, it also presents risks such as early fractures and complications. Continuous monitoring of outcomes is...