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This article presents an update on the surgical technique of the tissue sparing direct anterior approach (DAA) to the hip joint, MicroHip(TM). The DAA is the only approach following an intermuscular and interneural tissue plane to the hip. This technique is performed in a lateral decubitus position on a normal operating table and the overall soft tissue damage is reduced as leg traction is not necessary. This enables the approach to be used as a routine procedure for all indications. Most of the instruments used for this procedure are standard; only the acetabular reamers and positioners are angulated and specifically designed. The angled instruments are especially useful when performing hip replacement in obese patients. To date we have performed over 2500 MicroHip operations at this author's institute. The complication rate is minimal for well-trained surgeons and our experiences to date show that the method we have developed allows us to operate reliably on virtually any patient. At 5 years, results with the MicroHip technique are significantly better compared with a standard lateral approach, even in terms of Harris Hip Score. Important factors such as length of hospital stay, level of pain, blood loss, and time-to-return to work can be reduced significantly. The MicroHip technique is being used by more and more clinics all over the world, and can be applied with success after suitable training. Adv Venous Arterial Thrombos 2011;1(2):52-5.
Since first publication of the direct anterior approach (DAA) technique over 5 years ago [1], surgery for total hip arthoplasty (G??) has changed around the globe. The MicroHip technique is unique, and when first introduced seemed "exotic" to many people, even though other existing approaches to the hip, such as those pioneered by Smith-Petersen and Hüter, are also anterior approaches. Awareness of the anterior approach has now completely changed. The MicroHip technique is becoming more and more popular [2], and many different DAA techniques have been published using different patient positions and technical methods, and different types of traction table.
The purpose of this article is to provide an update on the MicroHip technique. This approach has evolved over the past few years as a consequence of the number of procedures performed (>2500 procedures at this author's institute alone). The postoperative and perioperative...