Approaches to Total Hip Replacem Approaches to Total Hip Replacement Surgery
James W Pritchett, MD Chief of Orthopedic Surgery, Swedish Orthopedic Institute; Active Staff, Swedish Medical Center
In 1939, Dr. Marion N. Smith-Peterson originated and popularized the direct anterior approach to the hip for placing hip prostheses. For many years, the approach was called the Smith-Peterson approach. It was known to be a relatively bloodless, direct, muscle-sparing approach into the hip that provided good visualization of the acetabulum. Smith-Peterson used a resurfacing femoral head prosthesis that had no stem. As stem-supported femoral prostheses were developed, placing them in the femur using this approach became more challenging.
Positioning the femur to achieve direct access to the femoral shaft requires the use of a curved femoral prostheses. Many of the early total hip prostheses had a curved stem, and the anterior approach was used.…