Direct two-incision total hip replacement without fluoroscopy

Minimal Access Surgery for Total Hip Arthroplasty – Current Beliefs and Activity Profile in The UK

“…Several techniques have been described, including the posterior approach, the anterolateral, the anterior and the two-incision approach, with or without fluoroscopic guidance. [8][9][10][11][12] Customised instrumentation including smaller retractors with extended handles, angulated reamers and implant introducers may be beneficial in performing the technique to prevent excessive trauma or traction of soft tissues, and are being aggressively marketed by manufacturers. 13 It is becoming increasingly difficult to assess objectively the short-term difference, as a patient who is aware of a smaller scar may automatically rehabilitate faster than a patient with a larger scar size.…”

Minimally invasive total hip arthroplasty

“…By combining the above surgical routes, THA can also be done by the double incision methods [1,[7][8][9][10][11] or the triple incision method [12]. The double incision method is a modified method of the direct anterior approach by Berger and Mears.…”

“…Under the fluoroscopic guidance, both the acetabular and the femoral component can be implanted in predetermined position. We and others have modified the two-incision technique by putting the patient in the lateral decubitus position [9][10][11]. The anterior skin incision is made perpendicular to the long axis of the femoral neck about 3 to 4 finger-breadth distal to the ilioinguinal line.…”

“…By this modification, the process of femoral canal preparation can be safely done under direct vision without the help of the fluoroscopic monitoring. [9][10][11]19] The triple incision method is similar to the double incision method. It can be done with the patient in the supine or in the lateral decubitus position.…”

“…One decreases the wound and muscle cutting and emphasizes the tissue repair through either a lateral or a posterior route. [1][2][3][4] The other spares muscle sectioning during the procedure through one [5,6], two [1,[7][8][9][10][11], or multiple [12] incisions. The abridged incision methods minimize the incision length and can be extensile if difficulties are encountered during THA.…”