Anterior supine intermuscular approach in total hip arthroplasty

Abstract

As societal pressure for decreased cost and improvement in postoperative rehabilitation has increased, so has the interest in minimally invasive techniques for total hip arthroplasty (THA). The direct anterior approach (DAA) on the fracture table for THA has recently gained popularity. The use of a specialized table has been associated with unique complications (i.e., ankle fractures) and does not easily allow for an intraoperative assessment of limb length and hip stability. In this chapter, the anterior supine intramuscular approach or DAA without the use of a fracture table will be reviewed, including the history of the DAA, specifics of the ASI technique, pearls and pitfalls, outcomes, and complications. This approach provides a safe and reliable approach for THA with improved recovery rates in the postoperative period.