The ABLE Anterior-Based Muscle-Sparing Approach: A Safe and Effective Option for Total Hip Arthroplasty

Hybrid of Smith-Peterson and Watson-Jones Minimally Invasive Direct Anterior Approach to the Hip Joint

“…The senior author of this technique noted had di culties reliably identifying the interval between TFL and abductors as originally described in the ABEL approach. 3 Doing the approach as we described increases the reliability and consistency in exploring the correct interval at the beginning of the case.…”

“…Muscle-sparing, more consistent acetabular component positioning with uoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients' expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint. [1][2][3] Pioneer surgeons Carl Hueter, Marius Smith-Peterson, and multiple other authors described the direct anterior approach to the hip which consistently utilizes the muscular interval between the sartorius and the tensor fasciae latae (TFL) muscle, which is known as the Hueter interval. 4 One limitation of this approach is the risk of damaging the lateral femoral cutaneous nerve (LFCN) as its main trunk usually runs along the medial border of the proximal TFL muscle.…”

“…4 In the early 2000s, Dr. Heinz Rottinger described the ABLE Advanced anterior Approach using the TFL and gluteus medius interval in a soft tissue-sparing fashion without abductor detachment while the patient positioned lateral decubitus position using peg boards. 3 In this technical note, we describe a minimally invasive soft tissue-sparing anterior approach to the hip where we incise the super cial thigh fascia as laterally as possible in protecting the LFCN with our super cial dissection, but instead of retracting the TFL laterally and exploring the Hueter interval, we bluntly develop an interval between TFL muscle belly and super cial fascia laterally, retracting TFL medically, hence, essentially exploring the muscle interval between TFL and gluteus medius without detaching any abductors from the greater trochanter in a supine position on a standard table.…”

Late Hematogenous Total Hip Infection After Revision for Mechanically Assisted Crevice Corrosion With Adverse Local Tissue Reaction

“…The patient is a 73-year-old male with a history of right MoP THA in 2010 for degenerative arthritis using an anterior-based muscle-sparing approach [ 10 ]. Components used were Trilogy acetabulum (with a 58-mm outer diameter and 32-mm inner diameter), an M/L Taper stem (size 12.5 with an extended neck offset), and a 32-mm Co alloy femoral head (Zimmer Biomet, Warsaw, IN).…”

Hybrid of Smith-Peterson and Watson-Jones minimally invasive direct anterior approach to the hip joint

“…Muscle-sparing, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients’ expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint [ 1 – 3 ]. Aging population expect rapid recovery, minimal invasiveness, and higher functions with anterior muscle-sparing approaches.…”