Surgical Approach in Primary Total Hip Arthroplasty: Anatomy Technique and Clinical Outcomes

Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of t...

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Bibliographic Details
Published in:Canadian Journal of Surgery 2015-04, Vol.58 (2), p.128-139
Main Authors: Petis, Stephen, MD, MSc, Howard, James L., MD, MSc, Lanting, Brent L., MD, MSc, Vasarhelyi, Edward M, MD, MSc
Format: Article
Language:fre ; eng
Subjects:
Anatomy & physiology
Arthritis
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - methods
Clinical outcomes
Fractures, Bone - epidemiology
Hip joint
Humans
Joint surgery
Medical research
Medicine, Experimental
Osteoarthritis, Hip - surgery
Postoperative Complications - epidemiology
Review
Surgery
Traction
Treatment Outcome
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Description
Summary:Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the surgical approaches. This review outlines some of the technical pearls of performing a THA through either a direct anterior, direct lateral or posterior approach. A literature review outlines the impact of surgical approach on clinical outcomes and clinically relevant complication rates.
ISSN:0008-428X
1488-2310
DOI:10.1503/cjs.007214