Minimally Invasive Anterolateral (Watson-Jones) Approach in the Supine Position

Abstract

Minimally invasive surgical approaches to total hip arthroplasty have recently gained a renewed interest as surgeons attempt to find techniques to decrease pain, accelerate patient recovery, and improve functional outcomes. Current muscle-sparing approaches to total hip arthroplasty include the recently popular direct anterior approach and the Rottinger anterolateral approach. Though the direct anterior approach through the Hueter interval has recently become popular, it has been abandoned by many surgeons due to its steep learning curve. In 2004, Rottinger described his modification to the anterolateral Watson-Jones approach performed with the patient in the lateral decubitus position. The clinical superiority of both anterior muscle-sparing approaches has been mixed and ill-defined in the literature with no definitive short- or long-term benefits compared with more traditional approaches to the hip. In this chapter, we describe a muscle-sparing anterolateral approach to total hip arthroplasty through the Watson-Jones interval performed from the supine position on a regular radiolucent operating room table.