Surgical Approach to the Hip: Direct Lateral Approach

ABSTRACT

The direct lateral approach was first described and named the transgluteal approach by Bauer in 1979 and was popularized by Hardinge K in 1982. In total hip arthroplasty, the direct lateral approach offers distinct advantages for the orientation of implants, access to both the acetabulum and proximal femur, and the preservation of soft tissue continuity between the gluteus medius and vastus lateralis muscle group. It can also be quite versatile, even in cases requiring extensive exposure, such as revision arthroplasty. The disadvantages include a risk of superior gluteal nerve injury, disruption of the repaired abductor mechanism, and postoperative heterotopic ossification. This review describes the surgical exposure of the direct lateral approach as well as the advantages and potential complications of the direct lateral approach.