Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted.

Introduction: There is widespread trend in total hip replacement to limit soft tissue damage. New approaches that respect the capsule and ligaments has been recently reported. The potential advantages of this approach is to improve short-term results in terms of stability, pain, length of stay, transfusions and complications.

Methods: From October 2015 to March 2016 the two senior authors performed 21 hips using the Superpath® technique, the measured variables included age, sex, operative time, acetabular inclination, pain assessment using visual analogue scale at 24 hours, need for transfusion, length of stay and complications. Surgical technique is described.

Results: 10 women and 11 men with a mean age of 56.57 (35-74) years. Average operating time was 102.85 (80-130) minutes. The mean acetabular inclination was 44.05 (26-60) degrees. The visual analogue scale (VAS) at 24 hours of the procedure was 2.38, standard deviation (SD) 0.9. The length of stay was on average 4.04 days 1.4 days shorter when compared with a cohort of patients treated using standard posterolateral. All patients were discharged to home. Two patients required transfusion, and in one patient with a calcar crack, crutches for 8 weeks were instructed. No patients were readmitted.

Discussion: The new generation of hip approaches have a strong anatomical basis, hip capsule preservation is a revolutionary concept, it ensures anatomical restoration, length and offset near to native joint. The Superpath® potentially minimises morbidity, reducing transfusion rates, allowing rapid recovery, shortening hospital stay and could save a significant cost to the healthcare system.