A Minimally Invasive Single Incision Anterior Approach for Total Hip Arthroplasty: Early Results in 49 Cases

A modified and limited Smith Petersen approach was used for prosthetic hip replacement. The exposure of the proximal femur required the use of a traction table. We operated on 49 patients: 15 of them underwent cemented bipolar hemiarthroplasty, and 34 had a total hip arthroplasty. Skin incision ranged from 6 to 11 cm (average 7.8 cm). Patients’ subjective grading was evaluated according to a pain scale (0–10); early functional outcome was rated on postoperative days two, seven and 30 according to a functional scale of active flexion and abduction. Average active flexion on the second postoperative day was 68.4°, and active abduction 14.7°. Progressive increment of average active flexion and abduction was observed on day 7 (78.7° flexion – 22.3° abduction) and day 30 (88.4° flexion – 29.2° abduction). All patients were allowed progressive weight-bearing depending on their postoperative pain. Most of them were fully weight bearing from the first day. This surgical approach, characterized by preservation of the muscular insertions, is associated with reduced postoperative pain and fast functional recovery.