Minimally invasive total hip arthroplasty via direct anterior approach

Background. Minimally invasive total hip arthroplasty (THA) aims at reduction of tissue damage to accelerate recovery. The anterior approach promises optimal soft tissue preservation. Patients and method. Safety and feasibility of minimally invasive THA via an anterior approach without the use of an orthopedic table was tested in a prospective cohort study on 100 consecutive patients. There were no exclusion criteria, and cementless and cemented techniques were employed. Results. No second incision was needed and neither nerve palsy nor dislocation was observed. The inclination angle of the cup was a median of 44.1 degrees and the position of the stem a median of 0 degrees varus/valgus. Short, satisfactory scars, little blood loss and postoperative pain, accelerated rehabilitation, and early discharge were noted. There were six cases of a permanent lesion of the lateral femoral cutaneous nerve. Conclusion. The proposed technique is safe and allows correct positioning of the cup and stem. It can be performed in a reasonable amount of time and blood loss is little.