Traditionally, the direct anterior approach to the hip has been called the "Smith Pete" approach. French orthopedic surgeon Emile Letournel modified this approach, using a fracture table. Then Dr. Joel Matta, an internationally respected pelvic surgeon in Los Angeles, brought this modified approach to the United States.

The anterior approach uses the "Hanna table," which is specifically designed for a direct anterior approach to the hip. This enables a surgeon to perform a minimally invasive total hip replacement with the least trauma to the soft tissues. The direct anterior approach provides truly muscle-conserving access to the hip joint. The muscles are retracted along an internervous plane. This spares splitting the gluteus maximus muscle or taking down the external rotator muscles to the hip, which occurs in both the traditional and the minimally invasive posterior approach to the hip.

The benefits of the anterior approach are threefold:

• There is minimal trauma to hip musculature.
  
• The risk of dislocation is reduced to below 1 percent.
  
• Radiography is routinely used in the procedure, assuring more precise positioning of components. The normal hip biomechanics are reproduced, which includes leg lengths and hip offset.

Some patients do experience slight numbness on the outside of the incision.

Dr. Hartford has been performing anterior hip replacements routinely since 2006.

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