Hemiarthroplasty Through a Direct Anterior Approach for Femoral Neck Fractures.

Abstract

This video demonstrates the direct anterior approach (DAA) for placement of an uncemented hemiarthroplasty for a displaced femoral neck fracture. The DAA is an intranervous and intramuscular approach that is believed to allow patients a quicker recovery and decrease the rate of dislocation. Femoral exposure is the most challenging component of the approach. In this video, the approach is performed with the assistance of the fracture table to facilitate exposure of the femur. This step-by-step description demonstrates how to expose the femur, measure for the femoral head size, and place an uncemented femoral stem in for a unipolar hemiarthroplasty. A full capsular closure is performed by reapproximating the iliofemoral ligament after reduction. This DAA video is taken from the surgeon's point of view to facilitate visualization of the anatomy and orientation of implant placement.