Minimally Invasive Total Hip Arthroplasty Using the Two-Incision Approach

Abstract

Minimally invasive hip replacement has the potential for minimizing surgical trauma, pain, and recovery in total hip replacement. These minimally invasive approaches for total hip surgery include single-incision and two-incision techniques. These approaches minimize sacrificing muscle and tendon yet still allow direct or indirect visualization for prepa­ration and component placement.

Specifically, searching for an approach to avoid transecting any muscle or tendon, thereby minimizing morbidity and recovery, a new approach was developed; the minimally invasive two-incision total hip procedure. This technique uses an anterior incision for preparation and insertion of the acetabular component and a posterior incision for preparation and insertion of the femoral component. This novel, minimally invasive, fluoroscopy-assisted, two-incision total hip arthroplasty uses a number of new instruments that have been developed to facilitate exposure and component placement. Standard implants with well-established designs are used to maintain the present expectation for implant durability. The following text describes the technique of the minimally invasive two-incision technique; combining an anterior, Smith-Peterson approach and a posterior incision that is like an intra medually (IM) femoral nail.

Adapted from Berger RA, Minimally invasive total hip arthroplasty using the two-incision approach, in Scuderi GR, Tria AJ, Berger RA (eds.), MIS Techniques in Orthopedics, 2006, New York, Springer, with kind permission of Springer Science + Business Media, Inc.