The Direct Anterior Surgical Approach for Hip Resurfacing Arthroplasty Without a Traction Table

Summary: The direct anterior muscle-sparing approach is described for hip resurfacing arthroplasty, without the use of intraoperative fluoroscopy, traction tables, or other special equipment. This surgical approach is based on an internervous plane and an extensile exposure, which can be adapted for hip resurfacing arthroplasty from experience gained with total hip arthroplasty. The anterior approach spares the major muscle groups around the hip and preserves a viable blood supply to the femoral head, leading to improved early recovery and preservation of living bone to support the resurfacing prosthesis. Analysis of digital radiographs demonstrates that component position is reliably achieved within the target range established for the procedure. This article contains the technical details of the procedure and documents the patient demographics, radiographic results, and early postoperative outcomes of the first 130 consecutive surgical cases performed by a single senior surgeon in our group (J.M.K.).