Anterolateral surgical approach for hip resurfacing arthroplasty

With appropriate patient selection and an experienced surgeon, hip resurfacing arthroplasty has demonstrated successful outcomes for patients with various operative indications. Hip resurfacing arthroplasties offer reported advantages over total hip arthroplasty, including improved stress transfer to the proximal femur, greater range of motion, and more natural gait mechanics. Traditionally, patients were only considered candidates for hip resurfacing arthroplasty in the treatment of osteoarthritis; recently, indications have expanded to include patients with osteonecrosis, rheumatoid arthritis, or dysplastic diseases of the hip. In the past, hip resurfacing has not been considered a minimally invasive procedure because of the technical difficulty posed to the surgeon. It is the opinion of the authors that with the appropriate knowledge and experience, minimally invasive techniques can be successfully applied to hip resurfacing arthroplasty, resulting in a comparable difficulty level to that posed by total hip arthroplasty. The purpose of this article is to discuss the relative indications and contraindications for hip resurfacing arthroplasty, as well as to present a minimally invasive anterolateral approach with techniques specific to hip resurfacing arthroplasty.