A Technique for the Minimally Invasive, Watson-Jones Approach to Total Hip Arthroplasty

Minimally invasive approaches to total hip arthroplasty have the potential to improve postoperative recovery by reducing tissue trauma and preserving musculotendinous units. The anterolateral (Hardinge) approach has been historically preferred by some surgeons because of a reduced risk of dislocation compared with the posterior approach. Unfortunately, violation of the anterior attachment of the abductor unit to the greater trochanter may lead to weakness and limp in some patients. In this paper, we describe a minimally invasive Watson-Jones approach to the hip, which aims at preserving the abductor unit to avoid postoperative weakness and limp. A combination of new instrumentation and positioning is described which facilitates the ability to perform this challenging approach. Although more difficult that the classical Watson-Jones approach, the minimally-invasive Watson-Jones approach provides most patients with a rapid recovery and rehabilitation and limits the risk of dislocation compared with the posterior approach.