Anterior approach to total hip replacement

The anterior approach for total hip endoprosthetics (THE) developed by K. J. Keggy was used in about 3,000 patients. It is characterized by rapid accomplishment, the possibility of anatomical inspection of the joint and correct orientation of the acetabular component of the endoprosthesis. Difficulties are not encountered in exposure of the femur and favorable conditions are provided for separation of the soft tissues. Considering our preference for noncemented THE, we have been using in the recent year a modified approach. The average duration of the operation, except for revision THE, did not exceed 90 minutes. The approach is atraumatic for the paraarticular soft tissues, which provides the possibility of early postoperative mobilization and rehabilitation and reduced the duration of postoperative in-patient treatment to 7.3 days. The incidence of complications was not higher, and in many respects was even lower, than that reported in the literature dealing with primary and revision THE. At present we still use the anterior approach in all operations for THE although essential contradictions occur in discussion of the advantages of cemented implants over noncemented prostheses. The suggested method for THE is best for most patients.