Beyond Minimally Invasive Total Hip Surgery with the Anterior Approach

The anatomy of the anterior approach: a cadaver study

“…Several approaches and methods have been investigated by authors such as Keggi and Grey (2005) 6 and Bal (2008). 4 These different methods all have the objective of finding a technique that causes the least structural damage, but allows the greatest access to the acetabulum for the placement of the acetabula component.…”

“…7 This approach is advised by certain surgeons, as the dissection is entirely within intermuscular planes. 2,6,[12][13][14] The anterior approach to hip arthroplasty has transformed from the use of the Hueter technique to the now popular Smith-Petersen technique. The Smith-Petersen approach is advised by some surgeons as the dissection is entirely within intermuscular planes.…”

“…The Smith-Petersen approach is advised by some surgeons as the dissection is entirely within intermuscular planes. 2,6,[12][13][14][15] The Hueter technique entails a surgical procedure performed with the patient in a supine position. The incision is made vertically, extending about 15 cm down from the anterior superior iliac spine (ASIS), passing between the sartorius and the TFL muscles.…”

“…19,20 Death could also result if the LCFA is severed. 6,8 In the attempt to demonstrate the possible ease of performing hip arthroplasty using the anterior approach, it was necessary to request the assistance of a surgeon with experience in both the anterior and the anterolateral approach.…”

“…[2][3][4][5] Different authors are, however, in agreement that the purpose of hip arthroplasty is to produce a painless, freely mobile and stable joint and for the patient to return to function post surgery. [4][5][6][7][8][9][10] The direct anterior approach was initially described by Hueter (1885), who looked through the interval between the tensor fascia latae (TFL) and rectus femoris; this technique has been suggested as being superior to the other available anterior approach techniques.…”