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A gap exists in the citation analysis literature with regard to the topic of DAA hip arthroplasty. As such, the purpose of this study is 2-fold. The first objective is to identify the 50 most influential publications, as measured by citation frequency, pertaining to DAA hip arthroplasty. The second objective is to compile a list of publications that functions as a guide for members of the orthopaedic community to use for knowledge base development and for advancing research in the field. Methods Given the publicly available nature of the data used in this study, institutional review board approval was not required. The Clarivate Analytics Web of Knowledge database was utilized to gather publications for inclusion in this cross-sectional study. On July 10th, 2019, the following Boolean search phrase was used to query the Web of Knowledge database and gather publications for analysis: “(Anterior OR Direct Anterior OR Smith-Peterson OR SmithPetersen) AND (Hip Arthroplasty OR Hip Replacement)”. No restrictions were placed on this search query across any categories including but not limited to language, journal, date of publication, or origin of publication. The search results were sorted by total number of citations in descending order. Titles and abstracts of these studies were then reviewed to determine which papers did not directly and exclusively relate to DAA hip arthroplasty. Subsequently, papers in which DAA for hip arthroplasty was not the primary topic were excluded from the analysis. Studies on indications, procedural descriptions, outcomes, and complications for DAA hip arthroplasty were included in our analysis. For studies with ambiguous inclusion or exclusion status after title and abstract review, the full article was obtained and reviewed by 2 of the authors, a senior orthopaedic resident and the senior author, a joint reconstruction specialist, to determine if it met the inclusion criteria. The top 50 most cited articles meeting the inclusion criteria were recorded and reviewed for author, year of publication, publishing journal, country of origin, citations each year since ArƟcles idenƟfied through database searching (n=2,046) ArƟcles reviewed by Ɵtle, abstract and text to reach 50 (n=264) (I)ArƟcles excluded because: (II)I. ArƟcles did not pertain to anterior hip arthroplasty (III)II. Anterior hip arthroplasty was not the main topic (IV)III. CitaƟon number did not qualify in the top 50 ArƟcles included for final analysis (n=50) Figure 1. Modified PRISMA flow chart. This flowchart demonstrates the selection process in identifying the 50 most cited articles regarding Direct Anterior Approach for Total Hip Arthroplasty. The initial search resulted in 2046 articles. Of these articles, the top 50 most cited relevant articles were identified within the first 264 search results. The remainder of the articles were excluded. Number of articles Decade of publication Articles by Year of Publication Figure 2. Total number of articles published per year. This demonstrates that most articles identified in the study have been published after 2009, with 2000-2009 being the second most productive period. C.M. Mikhail et al. / Arthroplasty Today 6 (2020) 190e195 191 Table 1 Top 50 most cited DAA total hip arthroplasty articles. Rank Article No. of citations (citation density) Level of evidence 1 Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res. 2005; 441:115-24. 253 (18.1) IV 2 Kennon RE, Keggi JM, Wetmore RS, Zatorski LE, Huo MH, Keggi KJ. Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am. 2003; 85-A Suppl 4:39-48. 214 (13.4) NA 3 Siguier T, Siguier M, Brumpt B. Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip replacements. Clin Orthop Relat Res. 2004; (426):164-73. 174 (11.6) III 4 Barrett WP, Turner SE, Leopold JP. Prospective randomized study of direct anterior vs postero-lateral approach for total hip arthroplasty. J Arthroplasty. 2013; 28(9):1634-8. 122 (20.3) I 5 Bergin PF, Doppelt JD, Kephart CJ, et al. Comparison of minimally invasive direct anterior vs posterior total hip arthroplasty based on inflammation and muscle damage markers. J Bone Joint Surg Am. 2011; 93(15):1392-8. 121 (15.1) II 6 Meneghini RM, Pagnano MW, Trousdale RT, Hozack WJ. Muscle damage during MIS total hip arthroplasty: Smith-Petersen vs posterior approach. Clin Orthop Relat Res. 2006; 453:293-8. 112 (8.6) NA 7 Jewett BA, Collis DK. High complication rate with anterior total hip arthroplasties on a fracture table. Clin Orthop Relat Res. 2011; 469(2):503-7. 105 (13.1) IV 8 Nakata K, Nishikawa M, Yamamoto K, Hirota S, Yoshikawa H. A clinical
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