The use of a direct anterior approach for elective hip replacement surgery has gained popularity over the last decade. This approach uses the distal extent of the Smith-Petersen interval, the Heuter approach, making it the only true anterior arthroplasty exposure to the hip. The advantages of this approach relate to the ability to expose and replace the articulation without detaching or transecting any muscles of the hip girdle, as well as the supine patient positioning. This approach carries the lowest reported dislocation rate, attributable to the accuracy in acetabular component positioning, the ability to accurately restore leg length and offset, and the maintenance of the dynamic musculotendinous stabilizers of the hip joint. Patients do not require postoperative "hip precautions" which, in combination with the muscle sparing nature of the exposure, allows for early functional return. While the benefits of this surgical approach have been documented in elective hip replacement, we find that these advantages profoundly improve the outcomes of patients treated for femoral neck fractures. This review describes the anterior approach arthroplasty, the benefits of this procedure in the management of femoral neck fractures and a detailed description of the surgical technique.
- Anterior approach
- Femoral neck fracture
- Total hip arthroplasty
ASJC Scopus subject areas
- Orthopedics and Sports Medicine