Advertisement

The Direct Anterior Approach to the Hip

  • Hiran Amarasekera
Chapter

Abstract

Total hip arthroplasty has been one of the most successful orthopedic procedures over the past 30 years. Currently, several surgical approaches for hip arthroplasty have been defined; these include the anterior, lateral, and posterolateral approaches. In literature the advantages and disadvantages of each surgical approach have been documented and which approach will be chosen depends on the experience of the surgeon. This chapter focuses on anterior minimally invasive surgery (AMIS). This surgical approach follows an intermuscular and inter-nervous plane to reduce the risk of injury to muscles, tendons, vessels, and nerves. This review discusses the history, technique, tricks, and pitfalls of AMIS procedure that reduces anatomical invasiveness and blood loss and speeds up the functional recovery of the patient.

Keywords

Hip replacement AMIS Anterior approach Minimally invasive hip surgery Hip-preservation surgery 

Notes

Acknowledgement

Figures and illustrations by: Dakshini Egodawatte MBBS (SAITM), Clinical demonstrator in Trauma and Orthopaedics Neville Fernando Teaching Hospital, Malabe, Sri Lanka.

References

  1. 1.
    Hunter SC. Southern hip exposure. Orthopedics. 1986;9:1425–8.PubMedGoogle Scholar
  2. 2.
    Jones W. Fractures of the neck of femur. Br J Surg. 1936;23:787–808.CrossRefGoogle Scholar
  3. 3.
    Smith Petersen MN. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg Am. 1949;31A:40–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Rachbauer F, Kain MS, Leunig M. The history of the anterior approach to the hip. Orthop Clin North Am. 2009;40:311–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Smith Petersen MN. A new supra–articular subperiosteal approach to the hip joint. J Orthop Surg (Phila, Pa). 1917;s2–15:593.Google Scholar
  6. 6.
    Judet J, Judet R. The use of an artificial femoral head for arthroplasty of the hip joint. J Bone Joint Surg. 1950;32(B):166–73.CrossRefGoogle Scholar
  7. 7.
    O’Brien RM. The technic for insertion of femoral head prosthesis by the straight anterior or Hueter approach. Clin Orthop. 1955;6:22–6.PubMedGoogle Scholar
  8. 8.
    Charnley J. Arthroplasty of the hip. A new operation. Lancet. 1961;1:1129–32.CrossRefPubMedGoogle Scholar
  9. 9.
    Charnley J. Total hip replacement by low friction arthroplasty. Clin Orthop Relat Res. 1970;(72):7–21.Google Scholar
  10. 10.
    Charnley J, Cupic Z. The nine and ten year results of the low friction arthroplasty of the hip. Clin Orthop Relat Res. 1973:9–25.Google Scholar
  11. 11.
    Tsukada S, Wakui M. Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five year average follow up results. Open Orthop J. 2015;9:157–62.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Sariali E, Leonard P, Mamoudy P. Dislocation after total hip arthroplasty using Hueter anterior approach. J Arthroplast. 2008;23:266–72.CrossRefGoogle Scholar
  13. 13.
    Amarasekera HW. Surface replacement of the hip joint. In: Fokter SK, editor. Recent advances in hip and knee arthroplasty. 1st ed. Croatia: Intech; 2012. p. 181–90.Google Scholar
  14. 14.
    Paillard P. Hip replacement by a minimal anterior approach. Int Orthop. 2007;31(Suppl 1):S13–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Oinuma K, Eingartner C, Saito Y, Shiratsuchi H. Total hip arthroplasty by a minimally invasive, direct anterior approach. Oper Orthop Traumatol. 2007;19:310–26.CrossRefPubMedGoogle Scholar
  16. 16.
    Nogler M, Mayr E, Krismer M. The direct anterior approach to the hip revisionOper Orthop Traumatol. 2012;24:153–64.CrossRefPubMedGoogle Scholar
  17. 17.
    Rachbauer F. Minimally invasive total hip arthroplasty. Anterior approach. Orthopade. 2006;35:723-4–6-9.CrossRefGoogle Scholar
  18. 18.
    Rachbauer F, Krismer M. Minimally invasive total hip arthroplasty via direct anterior approach. Oper Orthop Traumatol. 2008;20:239–51.CrossRefPubMedGoogle Scholar
  19. 19.
    Rodriguez JA, Deshmukh AJ, Rathod PA, et al. Does the direct anterior approach in THA offer faster rehabilitation and comparable safety to the posterior approach? Clin Orthop Relat Res. 2014;472:455–63.CrossRefPubMedGoogle Scholar
  20. 20.
    Zhang Z, Wang C, Yang P, Dang X, Wang K. Comparison of early rehabilitation effects of total hip arthroplasty with direct anterior approach versus posterior approach. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018;32:329–33.PubMedGoogle Scholar
  21. 21.
    Jahng KH, Bas MA, Rodriguez JA, Cooper HJ. Risk factors for wound complications after direct anterior approach hip arthroplasty. J Arthroplast. 2016;31:2583–7.CrossRefGoogle Scholar
  22. 22.
    Watts CD, Houdek MT, Wagner ER, Sculco PK, Chalmers BP, Taunton MJ. High risk of wound complications following direct anterior total hip arthroplasty in obese patients. J Arthroplast. 2015;30:2296–8.CrossRefGoogle Scholar
  23. 23.
    Barton C, Kim PR. Complications of the direct anterior approach for total hip arthroplasty. Orthop Clin North Am. 2009;40:371–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Kreuzer S, Leffers K, Kumar S. Direct anterior approach for hip resurfacing: surgical technique and complications. Clin Orthop Relat Res. 2011;469:1574–81.CrossRefPubMedGoogle Scholar
  25. 25.
    Khemka A, Mograby O, Lord SJ, Doyle Z, Al Muderis M. Total hip arthroplasty by the direct anterior approach using a neck preserving stem: safety, efficacy and learning curve. Indian J Orthop. 2018;52:124–32.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Post ZD, Orozco F, Diaz-Ledezma C, Hozack WJ, Ong A. Direct anterior approach for total hip arthroplasty: indications, technique, and results. J Am Acad Orthop Surg. 2014;22:595–603.CrossRefPubMedGoogle Scholar
  27. 27.
    Wayne N, Stoewe R. Primary total hip arthroplasty: a comparison of the lateral Hardinge approach to an anterior mini invasive approach. Orthop Rev (Pavia). 2009;1:e27.CrossRefGoogle Scholar
  28. 28.
    Faldini C, Mazzotti A, Perna F, et al. Modified minimally invasive direct anterior approach through a bikini incision for total hip arthroplasty: technique and results in young female patients. J Biol Regul Homeost Agents. 2017;31:83–9.PubMedGoogle Scholar
  29. 29.
    Amarasekera H. Surgical approaches to the hip joint and its clinical implications in adult hip arthroplasty. In: Kinov P, editor. Arthroplasty. 1st ed. London: Intech; 2013.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hiran Amarasekera
    • 1
    • 2
    • 3
  1. 1.Faculty Of MedicineUniversity of KelaniyaRagamaSri Lanka
  2. 2.University Hospitals of Coventry and WarwickshireCoventryUK
  3. 3.Warwick Medical SchoolCoventryUK

Personalised recommendations