Process-Optimized Minimally Invasive Total Hip Replacement via a Direct Anterior Approach with Navigation Control of Leg Length and Offset

The purpose of this study was to analyze a new concept of using the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with a leg positioner (Rotex-Table) and a modified retractor system (Condor). To control leg length and offset, the navigation system OrthoPilot® (B. Braun, Aesculap) or the Medacta system was used. We retrospectively evaluated the first 100 primary THRs performed with this new concept between 2009 and 2010, regarding the surgical data as well as the radiological and clinical outcome (Hip Disability and Osteoarthritis Outcome score, HOOS). All surgeries were perfomed following a standardized operation technique including navigation. The average age of the patients was 68 years (37–92 years), with a mean body mass index (BMI) of 26.5 (17–43).