Minimally Invasive Total Hip Arthroplasty with the Anterior Surgical Approach



Total hip arthroplasty (THA) with less surgical trauma is of interest to surgeons and patients because early recovery parameters are improved over standard techniques, and the procedure can be done with less surgical trauma and with shorter insicions.1,2 So-called minimally invasive THA (MIS-THA) procedures have been described with two small incisions, and in the hands of selected surgeons, the two-incision MIS-THA offers accelerated hospital discharge, and an earlier return to function when compared with traditional methods of performing THA.3,4 In the two-incision technique, the anterior incision and dissection are performed in the Smith-Petersen surgical interval. THA done with this method is a true muscle-sparing approach that is less invasive than any other method that divides or detaches tendons. Excellent outcomes of THA done with other variations of the anterior approach have been reported previously.57

Unlike the more commonly utilized posterior and direct lateral approaches to THA in the United States, the Smith-Petersen surgical approach allows access to the hip joint without dividing tendons or splitting muscle fibers. The two-incision MIS-THA is performed by implanting the acetabular component placement through the Smith-Petersen interval; femoral component placement is similar to an intramedullary rod placement during blind nailing of the femur.8 The advantage of the single-incision anterior approach is that implantation of both acetabular and femoral components can be achieved with a single incision alone. This chapter will describe the key steps in the single-incision anterior THA technique, identify potential dangers, and discuss the early clinical outcomes. The authors’ reasons for adopting this particular technique for routine primary THA were: (1) preservation of the hip musculature, (2) ability to accurately position prosthetic components and judge leg lengths, (3) to decrease complications, such as posterior hip dislocation, and (4) to increase patient satisfaction with THA.


Femoral Head Preoperative Templating Tensor Muscle Posterior Acetabular Wall Anterior Surgical Approach 


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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of Missouri-ColumbiaColumbiaUSA

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