A Modified Two-Incision Technique for Primary Total Hip Replacement

The complications and difficulty associated with the minimally invasive surgery (MIS) two-incision technique in total hip replacement have been well publicized. In this report, the authors describe a modified technique for primary total hip replacement, using two small incisions and no fluoroscopy during surgery. Instead, a stepwise approach and adequate visualization of the surgical field during each step of the procedure are used to reliably and reproducibly perform the operation. In reviewing 102 consecutive hips, neither serious complications nor radiographic malpositioning were found. Provided that the surgeon has received appropriate training and is familiar with the anatomy of the anterior thigh, primary total hip replacement can done safely with the MIS two-incision technique. The advantages of this procedure are the cosmetically appealing incisions, the preservation of muscles and tendons, and superior recovery and return to function.