Surgical exposures for primary total hip arthroplasty

Abstract

The proper selection of a specific surgical approach to the hip should be based on the following: anticipated exposure requirements (femoral, acetabular, and iliac); the location of prior incisions; preoperative leg lengths and range of motion; soft-tissue tension and integrity; patient size; surgical goals; and the surgeon's familiarity with the involved anatomy, both normal and pathological.all hip surgeons should be knowledgeable of anterior, lateral, posterior, and trans-trochanteric capsular approaches to the hip; more complicated extensile exposures are generally performed by the more experienced hip surgeons in complex primary and revision total hip arthroplasty (THa). Detailed anatomic exposures to the hip are discussed in several text books. The purposes of this article are to discuss surgical principles, pertinent anatomy, and indications, advantages, limitations, and results of the more commonly used surgical approaches for simple and complex primary THa.