Abstract
We present a retrospective review of the early results and complications in a series of 35 consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%), femur fracture (2%), greater trochanteric fracture (12%), postoperative periprosthetic intertrochanteric fracture (2%), femoral nerve palsy (5%), hematoma (2%), and postoperative iliopsoas avulsion (2%). Radiographic analysis revealed average cup anteversion of 19.6° ± 6.6, average cup abduction angle of 48.4° ± 7, stem varus of 0.9° ± 2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.
Highlights
Despite advances in implants and greater understanding of hip biomechanics, complications such as dislocation, abductor weakness, leg length discrepancy, and component malpositioning continue to plague recipients of total hip arthroplasties [1,2,3,4,5,6,7,8,9,10,11,12,13,14]
We have found capsulectomy to be preferable to capsulotomy as the divided capsule otherwise interferes with visualization and cup placement
One femoral shaft fracture occurred which was stabilized with cables as well as one greater trochanteric fracture that was fixed with cerclage wires
Summary
Despite advances in implants and greater understanding of hip biomechanics, complications such as dislocation, abductor weakness, leg length discrepancy, and component malpositioning continue to plague recipients of total hip arthroplasties [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. In attempts to circumvent these complications many investigators have recently turned to the anterior approach first described by J. It has been referred to as a minimally invasive technique that allows exposure of the proximal femur and acetabulum through a small incision without the need to cut muscles or perform osteotomies. This should lead to shorter recovery time and fewer major complications that have been associated with the more traditional approaches
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