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Direct Anterior Approach for Hip Hemiarthroplasty

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Dustin Hoffman, Eric Miller, Andrew Wroblewski

This video shows a surgical technique for the direct anterior approach to the hip, as indicated for hemiarthroplasty or THA after a displaced femoral neck fracture. We first discuss indications for this approach. We show patient postioning in the OR, followed by a layer by layer dissection of the direct anterior approach. This includes incising the superficial TFL fascia, followed by the incision through the backside of the TFL fascial layer between the rectus and gluteus medius, then a capsulectomy. Preferred retractor placement is discussed at each step of the approach. A standard hemiarthroplasty is then performed.