Abstract
INTRODUCTION
The direct anterior approach to THR has become an increasingly popular minimally-invasive technique in an effort to minimize dislocation risk, facility early recovery, and diminish soft tissue injury. However, it has been associated with unique complications including intraoperative femur fracture, cutaneous nerve palsy, stem subsidence, and wound healing complications. These risk of these complications have been documented to be more likely in the surgeon's early experience with the approach. The minimally-invasive Supercapsular Percutaneous-Assisted (SuperPATH) technique was developed to minimize capsular and short-external rotator injury, minimize dislocation risk, and provide an easier transition from the standard posterior approach.
METHODS
Fifty (50) consecutive elective total hip replacements in 48 patients were performed using the SuperPATH technique. These also represented the first fifty elective THRs the surgeon performed in practice. Indications were primary or secondary osteoarthritis (92%), avascular necrosis (6%), and impending pathologic fracture (2%). Patients were evaluated retrospectively for dislocation, major, and minor complications.
RESULTS
At average follow-up of 10.9 months (Range 1–27 months), there were no dislocation events. There was one periprosthetic fracture identified at 14-day follow-up that required femoral revision surgery in an elderly female patient with osteoporosis. Otherwise, there were no reoperations for any reason. There were no wound complications or deep infections. There was one stem subsidence (2%) of 4 mm. There were no neurovascular injuries.
CONCLUSION
The SuperPATH technique can likely be performed at an early experience level with low early complication risk and lower early dislocation risk. This minimally-invasive technique deserves further interest and evaluation as it may present a gentle learning-curve to surgeons.
