[Minimally invasive anterior approach].

Area of Science:

• Orthopedic Surgery
• Surgical Techniques

Context:

• The direct anterior approach (DAA) for total hip arthroplasty (THA), first described in 1985, has evolved significantly.
• This technique leverages the interval between the tensor fasciae latae and sartorius muscles for hip joint access.
• It aims for muscle preservation and a direct surgical route.

Purpose:

• To describe the technique, associated risks, and current clinical outcomes of minimally invasive direct anterior approach THA.
• To compare the DAA with the traditional transgluteal lateral Bauer approach.
• To analyze literature and own results, focusing on lateral cutaneous nerve of the thigh (NCFL) lesions, tensor fasciae latae muscle damage, and acetabular cup positioning.

Summary:

• The DAA provides efficient hip joint access with good muscle preservation.
• Potential risks include damage to the lateral cutaneous nerve of the thigh (NCFL) and the tensor fasciae latae muscle.
• Acetabular cup positioning can be challenging due to limited visualization in the minimally invasive technique.

Impact:

• Highlights the benefits of muscle preservation in THA.
• Identifies specific risks associated with the DAA, informing surgical planning and patient counseling.
• Discusses the trade-offs between minimally invasive approaches and traditional methods regarding surgical control and outcomes.