Related Experiment Video
Updated: Feb 10, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Direct anterior approach to the hip joint in the lateral decubitus position for joint replacement
R S Camenzind1, K Stoffel2,3, N J Lash4,5
1Clinic of Orthopaedic Surgery, Luzerner Kantonsspital Luzern, Spitalstraße, 6000, Lucerne 16, Switzerland. roland.camenzind@bluewin.ch.
Surgical Principle And Objective:
The direct anterior approach for total hip arthroplasty is associated with higher complication rates and difficult femoral component positioning. Performing a modified technique in the lateral position allows secure component positioning.
Indications:
Primary hip replacement (including femoral neck fracture) and cup revision without bone deficiency.
Contraindications:
Destruction/deformities of proximal femur or acetabulum, bone deficiency or malignancy.
Surgical Technique:
Strict lateral decubitus position. Straight anterior incision of 10-12 cm, starting 2 cm lateral to the anterior superior iliac spine. Incision of the fascia over the tensor fascia lata muscle (TFL). Lateral retraction of the TFL. Incision of the fascia and medial retraction of rectus femoris. Ligation of the ascending branch of the lateral femoral circumflex artery. Detachment of the iliocapsularis muscle from the capsule in a medial direction. Anterior capsule excision. Femoral neck osteotomy and removal of the head. Reaming of the acetabulum; insertion the acetabular component. Exposure of the femur. Incision/excision of the capsule medial to the greater trochanter for easy anteriorization of the femur. Reaming and implantation of femoral component.
Postoperative Management:
Weight bearing on day one with crutches for 4 weeks; deep vein thrombosis prophylaxis.
Results:
In all, 138 patients (72 women, 66 men, mean age of 67 years) were followed up over 2 years. Overall complication rate was 3.6%: 3 patients (2.2%) with grade III complications required additional intervention. Acetabular cup inclination: 35-50° in 88% of patients. Neutral femoral stem position observed in 99% of patients. Mean Harris hip score improved from 61 preoperatively to 97 after 2 years. Patient satisfaction on a visual analogue scale improved from 3.7 to 9.5.
More Related Videos
09:31Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Related Concept Videos
Structural Joints: Synovial Joints
Structural Joints: Fibrous Joints
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
Structural Joints: Cartilaginous Joints
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
Joints
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...
Method of Joints
Since plane truss members are in the same plane, each joint is subjected to a coplanar and concurrent force system. To apply the method of joints, the first step is to...
Introduction to Joints