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Accessory Incisions in the Direct Anterior Approach to Total Hip Arthroplasty

March 01, 2017

Contributors: Tamara John, MD; Kristaps J Keggi, MD; Stephen Nelson, MD; Stephen Nelson, MD

The direct anterior approach to total hip arthroplasty without the use of a traction table provides fast and easy access to the hip joint in patients who are thin; however, with the rising obesity pandemic, femoral and acetabular exposure has become exceedingly difficult in patients who are muscular and patients with obesity. Rather than drastically increase incision and dissection, this video demonstrates possible accessory incisions that facilitate acetabular and femoral preparation and component placement. The goal of the video is to instruct surgeons on how to easily and effectively perform arthroplasty with the use of accessory incisions, as needed. Special emphasis is placed on setup, draping, incision, dissection, retractor placement, bone preparation, component positioning, prosthesis placement, and leg length assessment. Each step of the procedure is further clarified with the use of original illustrations.

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