Anterior Double-Incision Lateral Decubitus Approach

Abstract

Total hip arthroplasty has become a commonplace and highly successful surgical procedure. Improvements in prosthetic design and bearing surfaces have led to expanded indications for hip replacement in younger, active patients. The demands of younger patients and increased expectations for earlier return to activity in older patients has led to a growing interest in less invasive methods of total hip arthroplasty. Mini-incision anterior, posterior, and multiple incision approaches have been described [1, 3, 4, 6–8]. So-called muscle-sparing procedures utilizing a modified anterior Smith-Petersen approach have been promoted as the least disruptive approach to the soft tissues in hip arthroplasty. There has been some hesitancy amongst surgeons to adopt these newer techniques that employ different surgical approaches to the hip when combined with a different patient positioning. The majority of North American surgeons have traditionally performed total hip arthroplasty with the patient in the lateral decubitus position.