Direct anterior approach surgeons significantly overstate the benefits of this approach relative to other surgeons: a view of online promotion in Ireland, Australia, New Zealand and the UK.

Background: Growing patient interest in the direct anterior approach (DAA) has led to increased Internet promotion by surgeons.

Aims: The aim of this study was to investigate Internet promotion of the DAA by surgeons in Australia, New Zealand, Ireland and the UK. Further, we aimed to determine if surgeons offering the DAA discussed the potential benefits of the approach more frequently than other surgeons.

Methods: Orthopaedic surgeons were identified from the websites of the Australian Orthopaedic Association, New Zealand Orthopaedic Association, UK National Joint Registry, and Irish Institute of Trauma and Orthopaedic Surgery. Each surgeon website was investigated for claims made regarding the risks and benefits of the DAA, as well as the literature used to support these claims.

Results: In total, 6.4% (n = 177) of websites identified mentioned the DAA: 128 (72.3%) websites were associated with surgeons offering the DAA, while 49 (27.7%) websites were associated with surgeons not offering the DAA. Potential benefits were mentioned in 74% of websites, while 36.7% made reference to risks; 9% cited peer-reviewed literature. When comparing websites of surgeons who offer the DAA with the websites of surgeons who do not, there was a statistically significantly increased rate of mentioning any benefit (p = 0.016), less tissue damage (p = 0.041), less blood loss (p = 0.004), faster recovery (p = 0.004), and fewer dislocations (p = 0.002).

Conclusion: A small number of surgeons in these countries promote the DAA online. Surgeons offering the DAA are more likely to report the potential benefits of the procedure than surgeons not offering the DAA.