A “Modern” posterior approach: “The Back Is Back”

In recent years the direct anterior approach (DAA) to total hip arthroplasty has gained in popularity. This increased interest in the DAA took place at a time when surgeons using a traditional posterior approach were struggling with dislocation risks and slowed recovery due to now outdated, and largely abandoned, techniques combined with older style implants. However, at the same time that the DAA gained in popularity, the standard posterior approach was also being modified. It has been adapted to work with newer instrumentation and modern cementless implants which also offer an expanded array of sizing and dimensioning versatility. We present a contemporary, iliotibial band sparing, minimally invasive posterior approach that we believe achieves the same degree of soft tissue preservation, with similar early recovery benefits as compared to the DAA. This highly modified posterior approach offers a lower risk profile and the potential for stepwise adoption and a surgeon controlled learning curve.