Minimally invasive direct lateral approach

Abstract

The development of minimally invasive techniques along with implementation of rapid recovery pathways has improved patient recovery from total hip arthroplasty (THA). The traditional direct lateral approach afforded great access for THA with low dislocation rates, but came at the cost of prolonged recovery of the abductor mechanism. Over the years, the direct lateral approach has been modified to minimize release of the abductors and lessen soft tissue dissection, which has been aided by the development of MIS instrumentation. The MIS direct lateral approach allows familiar patient positioning, does not require special OR tables, and can be used for both primary THA and revision surgery. With this approach, exposure to both the femur and acetabulum is easily accomplished. Patients will have a more rapid recovery with shorter hospital length of stay, and dislocation rate remains low. In this chapter, we describe the surgical technique for MIS direct lateral total hip arthroplasty and discuss the literature supporting its use.