(iv) Surgical approaches in primary total hip arthroplasty – pros and cons

Primary total hip arthroplasty has been one of the most successful orthopaedic procedures of the last century. Several classical surgical approaches to the hip have been described. Each approach has advantages and disadvantages. Recently, minimally invasive techniques have been developed with incisions less than 10cm. The goals of minimally invasive surgery are minimal soft tissue damage and a shorter hospital stay, faster recovery and return to work, less pain, and improved cosmetic results. The disadvantages are less visibility, longer operation time, nerve injuries, higher incidence of femoral fractures, malposition of the components and a long learning curve. The originator results with these techniques were promising. Subsequently, more controversial results have been published. Further follow-up and development is necessary to compare the results with the classical proven approaches.