Abstract
The anterolateral MIS-THA approach can be divided into the Modified Watson-Jones approach (MWJ) performed in the lateral position and the Anterolateral Supine method (ALS) performed in the supine position. Femoral preparation is flexible in stem selection in the MWJ method. On the other hand, the ALS method is more stable for placement on the acetabular implant.
Now we introduce novel anterolateral MIS approach named AL60, it makes use of the merits of both MWJ and ALS methods.
Technique
The patient is fixed at 30 degrees on the dorsal side from lateral position. That is 60 degrees on the half side from the horizontal plane, and the platform of the operating table is removed just as in the MWJ method. During surgery, the pelvis is fixed by the posterior support, and the stability of the pelvis is very good. Also, if the inclination is accurate at 30 degrees, by holding the holder parallel to the operating table when inserting the cup, the cup is theoretically inserted at Anatomical anteversion 30 degrees. The intraoperative field of view is also visible to the assistant due to the semi-lateral position.
Femoral preparation is easier than the MWJ method because the affected limbs have fallen to the dorsal side already.
Discussion
Since March 2017 to the end of August 2018, the AL60 method was used for 207 primary THA. There were no dislocations or fractures and any other complications.
Full weight bearing was possible from the next day.
The AL60 method has stability of the ALS method for acetabular preparation and the operability of the MWJ method for femoral preparation.
Therefore, it can be said that new AL60 approach method makes use of the merits of both MWJ and ALS methods.
