Direct Superior Total Hip Replacement


The field of joint replacement surgery is constantly evolving, and new technologies are making total hip replacement surgery a safe, viable option for a growing number of patients. At the Orthopaedic Institute of the West in Phoenix, AZ, esteemed orthopaedic surgeon Dr. Brandon Gough is excited to offer the Direct Superior Total Hip Replacement procedure, a micro-invasive surgical technique that incorporates state-of-the-art technology, and has a remarkably high record of successful outcomes. Dr. Gough is one of a few surgeons in the country offering this latest muscle sparing procedure for hip replacement.

Western Orthopaedic Institute is currently the only practice in Phoenix, Arizona, to offer this revolutionary hip surgery approach, which allows the surgeon to avoid forcing the patient’s leg into an abnormal position during surgery and prevents damage to any of the patient’s muscles and tendons. These surgical technique modifications minimize soft tissue damage and effectively shorten the requisite post-surgical recovery period, enabling patients to resume the activities they enjoy with less down time.

The direct superior approach offers a multitude of benefits, including:

  • Reduced post-procedural occurrence of hip dislocation
  • Earlier ambulation minimizes complications commonly seen with traditional hip replacement (i.e. blood clots and muscle fatigue)
  • No hip precautions after surgery—many patients resume normal activities much earlier than expected and the whole recovery process is much faster and less painful than with traditional techniques
  • Requires only one small incision in the hip, leaving muscles and tendons undamaged and preserving the hip’s natural alignment
  • Less leg manipulation and less soft tissue damage allows for earlier return of function, less pain, and greater stability after hip replacement
  • Accurate implant positioning is achieved, which allows for longevity of the hip replacement
  • Surgery may be performed on an outpatient basis (or a one night hospital stay)
  • More comfortable recovery period, with minimized pain medication requirements
  • Minimization of blood loss (compared to traditional hip replacement techniques)
  • Fewer incidences of complications during and after surgery

Procedure and Recovery

For the direct superior hip replacement approach, Dr. Gough will make a single incision on the outside of the hipin the buttock region, which will allow adequate exposure to perform the surgery accurately and with very little soft tissue damage.  He will work through the small incision and meticulously work to preserve the muscles around the hip joint, in order to place the hip implant with the least amount of soft tissue trauma as possible.. After securely placing the implant, Dr. Gough will meticulously repair the hip capsule and skin to facilitate proper healing and prevent dislocation of the hip.

After surgery, many of Dr. Gough’s patients are up and walking without assistive devices in as little as 4 hours, and most patients have minimal post-operative pain, which can easily be controlled with tylenol and celebrex.  Dr. Gough’s patients usually only stay one night in the hospital and are discharged to go home the next day after surgery—some patients have even been discharged on the same day of the surgery!  This new approach requires less muscle dissection, yet still effectively stabilizes the hip region.  There are no staples or sutures to be removed after surgery, and patients are not limited by post-surgical restrictions or hip precautions.

As with traditional hip replacement surgery, physical rehabilitation is a critical component of recovery. Dr. Gough will work with your physical therapist to compose a customized treatment plan with specific exercises to help increase your range of motion and restore your strength after surgery.


Brandon Gough, M.D. specializes in orthopaedic surgery of the hip and the treatment of degenerative, potentially debilitating orthopaedic issues. His primary treatment objective is to deliver high-quality patient care in a welcoming, compassionate environment. Dr. Gough utilizes cutting edge orthopaedic techniques that are designed to:

  • Minimize the risk of complications
  • Safeguard the health of his patients
  • Alleviate any discomfort
  • Expedite the post-procedural recovery period

In addition to his private practice at the Orthopaedic Institute of the West in Phoenix, Dr. Gough maintains operating privileges at St. Luke’s Hospital and Thompson Peak Hospital in the Phoenix/Scottsdale, Arizona area. If you would like additional information about Direct Superior Total Hip Replacement surgery, please contact our office today. We look forward to speaking with you, and to scheduling your initial consultation with Dr. Gough.

BrandonGough MD