[Minimally invasive total hip arthroplasty via direct anterior approach]

Abstract

Background: Minimally invasive total hip arthroplasty (THA) aims at reduction of tissue damage to accelerate recovery. The anterior approach promises optimal soft tissue preservation.

Patients and method: Safety and feasibility of minimally invasive THA via an anterior approach without the use of an orthopedic table was tested in a prospective cohort study on 100 consecutive patients. There were no exclusion criteria, and cementless and cemented techniques were employed.

Results: No second incision was needed and neither nerve palsy nor dislocation was observed. The inclination angle of the cup was a median of 44.1 degrees and the position of the stem a median of 0 degrees varus/valgus. Short, satisfactory scars, little blood loss and postoperative pain, accelerated rehabilitation, and early discharge were noted. There were six cases of a permanent lesion of the lateral femoral cutaneous nerve.

Conclusion: The proposed technique is safe and allows correct positioning of the cup and stem. It can be performed in a reasonable amount of time and blood loss is little.