Anterior Primary Total Hip Arthroplasty

Total hip arthroplasty (THA) is the preferred treatment for end-stage osteoarthritis of the hip. The posterior, posterolateral, direct lateral, anterolateral, or the anterior approaches are the currently established surgical approaches for THA. Over the last decade, the anterior approach has gained increasing popularity. Its muscle-sparing nature and flu -oroscopy-guided component positioning are the most important benefits. It has been suggested that postoperative recovery is facilitated by an anterior approach. Patients do not need to follow hip precautions, and can return to driving after 1 week. The anterior approach uses a muscle interval between the tensor fasciae latae and the rectus femoris to open the capsule without detachment of muscles. Especially, the external rotators and posterior capsule remain intact and reduce the risk of posterior dislocation. Accuracy of acetabular component positioning has an impact on postoperative dislocation rates, polyethylene wear, and impingement. When the operation is done in a supine position, fluoroscopy is available to check the acetabular component inclination and anteversion during THA as well as leg length and offset. The current chapter reports on the surgical approach, surgical technique, and results of anterior THA.