Anterior approach to hip arthroplasty

Abstract

Direct anterior approach to the hip joint utilizing a curved transverse skin incision and splitting the tensor fascia muscle longitudinally provides an effective exposure for carrying out primary total hip arthroplasty. Excellent visualization of the acetabulum is afforded by this direct approach. Modified femoral rasps of varying lengths are employed to rasp the femur with the leg in external rotation. Trochanteric osteotomy was carried out on only three occasions in a series of 104 procedures performed on 85 patients during a three-year period. The duration of operation averaged 65 minutes. Average blood replacement was 1.9 units in unilateral hips and 3.5 units in patients operated upon sequentially. Mean postoperative stay was 12.8 days following unilateral and 22.3 days following bilateral surgery. Four patients experienced perioperative complications. The anterior approach provides a safe and effective approach to total hip arthroplasty with limited morbidity.