Anterior Path - Tissue Sparing Surgical Hip Approaches
From Hips - Tissue Sparing Surgical Approaches
The use of the cannula allows for a transverse incision to be made more superior and lateral, minimizing many challenges related to the femur and wound healing. The placement and orientation of the incision create excellent femoral exposure, alleviate challenges related to femoral preparation, and allow the use of any stem philosophy. The use of a portal to prepare the acetabulum allows direct visualization and in-line reaming and cup impaction.
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Direct Anterior Wound Complications
The incidence of wound complications is 7 times higher with the use of the Direct Anterior approach, and does not improve with surgeon experience.8
- Utilizing a Direct Anterior approach Skin incision is not in line with Langer’s lines, which correspond to the natural orientation of collagen fibers in the dermis
- Wound is under constant tension
- Poor wound perfusion
Anterior® Path Incision Benefits
The Anterior Path® incision is made in line with Langer’s lines and just below the hip crease, providing a number of benefits9:
- Improved Wound Cosmesis
- Improved Wound Healing10
- Fewer Wound Complications
Anterior Path® & The Lateral Femoral Cutaneous Nerve
Retraction required by the Direct Anterior approach to gain access to the hip has led to injury of the LFCN, which results in tingling, numbness and burning pain in the patient’s thigh. Due to the change in the location and orientation of the incision in Anterior Path®, the Lateral Femoral Cutaneous Nerve (LFCN) is more easily avoided. A study on DA showed that a transverse incision reduced subsequent anterior thigh numbness by nearly half.9
- A comparative study of Direct Anterior shows that in 964 patients there was approximately 1.9 times as much numbness with a longitudinal incision versus a bikini incision.9
With the Anterior Path® approach, the orientat...
With the Anterior Path® approach, the orientation of the incision is oblique v. longitudinal. Additionally, this oblique incision is made more superior and lateral. The nature and location of the incision has several benefits, including:
- Improved visualization and access for broaching & stem placement
- Eliminates the need for double offset broach handles
- Minimize femoral complications, potentially including peri-prosthetic fracture
- Easier femoral preparation
- Supports all stem philosophies
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