The anterolateral Watson Jones approach in total hip replacement in the supine position

Abstract

The anterolateral approach to the hip, described in 1936 by Sir Watson Jones, still is in current use when implanting THA. This mini-invasive approach, in which neither muscle nor tendon is divided, is developed using the space between the gluteus medius and the tensor fascia lata. The surgical technique is described in the supine position, using a special skin incision and personal modifications in order to preserve the abductor muscles. The use of special reamers and the lowering of the legs allow easy preparation of the femur and constant preservation of the gluteus medius and the superior gluteal nerve. Advantages claimed for this approach in the supine position are an accurate positioning of the cup, a very low rate of dislocation, low vascular or neurological risks and a low rate of deep veinous thrombosis. The complications, indications and limitations of such an innovative technique are also evoqued here.