Total hip arthroplasty with a superior approach and in situ preparation of the femoral stem: technique and feasibility in a prospective series of 80 cases

Acta Orthop Belg. 2022 Mar;88(1):35-42. doi: 10.52628/88.1.05.

Abstract

We report on the feasibility of a technique for total hip replacement with in situ preparation of the femoral stem through a superior approach and with the use of standard instruments. From December 2017 to august 2018, 100 patients were recruited for total hip replacement. 80 patients underwent THA through a superior approach with femoral broaching before femoral neck cut. We evaluated feasibility, complications and early functional outcome. There were no major complications. Postoperative leg length discrepancy was on average +0.6mm and offset -0.5mm. The mean acetabular cup inclination was 42.0° and the mean anteversion was 14.5°. The mean WOMAC score was 46 before, 76 at 1 month and 86 at 3 months after surgery. Functional scores (OARSI) were significantly improved at 3 months. Superior in situ total hip replacement is a reliable and reproducible technique with an excellent clinical outcome. It is an iteration to the posterior approach, hence the learning curve is steep and if needed, conversion to a standard posterior approach is possible.

MeSH terms

  • Acetabulum / surgery
  • Arthroplasty, Replacement, Hip* / methods
  • Feasibility Studies
  • Hip Prosthesis*
  • Humans
  • Prospective Studies
  • Retrospective Studies