Basic Anatomy of Direct Anterior Approach for Mini-Invasive Hip Surgery

Abstract

Background: The direct anterior approach (DAA) for mini-invasive hip surgery is becoming a preferred method owing to its reported benefits. The aim of the present study was to identify and describe the structures that are potentially at risk during the execution of this surgical procedure, as well as to discuss the potential advantages of using DAA in total hip arthroplasty (THA). Methods: Twenty sides adult embalmed cadavers (12 male and 8 female) were examined at the Department of Anatomy, Histology and Embryology at the Medical University of Sofia, Bulgaria. We performed the incision of anterior approach and studied its relation to structures in proximity to the hip joint. Results: We identified the lateral femoral cutaneous nerve and the lateral femoral circumflex vessels as being potentially at risk when DAA to the hip joint is performed. We also observed and described their location and course and did not report the presence of any variations. Conclusion: This study demonstrates the location and course of the anatomical structures that may be encountered and damaged during DAA and provides important information intended to help surgeons minimize the risk of neurovascular injury.