[The MIS anterolateral approach for THA]

Abstract

The MIS anterolateral approach for hip replacement surgery uses the intermuscular plane between gluteus medius and tensor fascia latae. The patient is placed in the lateral position. Retractors with soft tissue friendly profile and an operating table with modified leg support are recommended. The technique provides very good exposure of the acetabulum and femur and preserves muscle integrity so that rehabilitation can be rapid. Currently the experience comprises over 1000 primary cases performed using the MIS anterolateral approach since March 2003. The clinical results including pain, blood loss, range of motion, functional score, Harris Hip Score, and radiographic studies are based on the complete examinations of 48 consecutive patients. There are significant differences with improved clinical results compared with patients after standard approaches. After a fundamental learning curve there is no evidence of increased complications. The anterolateral approach is a standard approach suitable for wide application. The experience includes difficult primary cases like dysplasia, rheumatic disease, and ankylosis and even for revision surgery the technique can be routinely used. Restrictions are not known either in patients' characteristics or in indications.