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Direct Anterior Approach for Total Hip Replacements

The Direct Anterior Approach utilises a muscle sparing approach. It is the only truly internervous and intermuscular approach of all total hip replacement approaches. It uses the superficial interval between the muscles of sartorial and tensor fascia latae. The capsule is incised in a particular fashion to facilitate excision or repair. An excision of the capsular structures at the end of the case is performed if the capsule is thickened and abnormal, as is often the case in hip arthritis.

Other approaches to the hip include the Posterior Approach, the Lateral Approach and the Anterolateral Approach. All of these approaches have been used for total hip replacements in the past, however none of them are truly internervous or intermuscular. Current literature suggests that the dislocation rate for the Posterior Approach is more than that of the Lateral approach. This is because the position of instability becomes the back of the hip joint, where the tissues are cut in order to dislocate the hip during prosthesis insertion. In the Direct Anterior Approach for Total Hip Replacements, this is not the case, as the posterior structures are kept intact. After other approaches to the hip, there are numerous precautions that must be adhered to. This includes sitting in low chairs, care when sleeping on your side, inability to cross your legs and more. The restrictions long term for total hip replacements performed using the minimally invasive direct anterior approach are minimal. All approaches to the hip can be used successfully.

Dr Chien-Wen Liew believes in muscle sparing approaches for all his surgical techniques (Hip, Knee and Shoulder). He uses the Direct Anterior Approach for Total Hip Replacements as well as for Femoroacetabular Impingement surgery in athletes. There is also a likely reduction in serious (i.e. motor disturbing) nerve injuries via the Direct Anterior Approach.
For more information on the Direct Anterior Approach for total hip replacements or FAI surgery, please make an appointment with Dr Chien-Wen Liew on (08) 7099 0188

Dr Chien-Wen Liew is a fellowship trained orthopaedic surgeon who has spent 2013 refining the techniques for the Direct Anterior Approach. This truly minimally invasive approach has improved the post operative care of patients. Dr Liew performs all total hip replacements in private via the Direct Anterior Approach. Some revision surgery can also be performed with this technique depending on various factors.

Please consult your doctor or seek a 2nd opinion prior to consideration if this approach is suitable for you.

Minimally Invasive Hip Surgery

Dr Chien-Wen Liew was an invited guest speaker at the M.O.R.E symposium on Hip Arthroplasty in Sydney. On November 29th, Dr Liew spoke on his experiences with the direct anterior approach

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Orthopaedics 360

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

Southern Specialist Centre

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

Health @ Hindmarsh

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

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Rugby Union SA partnership

Orthopaedics 360 are proud to be partnered with Rugby Union SA. With one of the most active sporting clubs in South Australia, we have acknowledged the growing need for customised care for the growing and established athletes.

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Orthopaedics 360

A: 94-96 Fullarton Road, Norwood 5067

P: (08) 7099 0188

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