Less invasive approaches in total hip arthroplasty. Is anterior superior?

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With changes in healthcare reimbursement, increasing patient education regarding surgical techniques, patient desire for quicker return to function, and shorter hospital stays, the direct anterior approach is gaining traction around the field of total hip arthroplasty. Early reports on the direct anterior approach for total hip arthroplasty cited high complication rates, a steep surgeon learning curve, and no significant difference in patient outcome. In this review, we evaluate the current literature to answer questions about total hip arthroplasty in regards to the direct anterior approach. The direct anterior approach utilizes the plane between the sartorius and tensor fascia lata muscles to form a true internervous and intermuscular plane, theoretically reducing postoperative pain and inflammation and facilitating faster hospital turnover and better patient satisfaction.

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