Anterior Minimally Invasive Approach (AMIS)

Anterior approach hip replacement surgery is characterised by preservation of muscles, nerves and tendons encountered during the surgery, offering a reduced skin incision.
The advantages of anterior minimally invasive surgery are:

    In comparison with “conventional” surgical  techniques, the AMIS approach can reduce the post-operative pain as muscles are not cut.
    Rehabilitation can usually start the day of the operation or the day after. Standing up and walking with arm crutches can start immediately.
    The AMIS technique usually significantly reduces the duration of hospital stay. Your surgeon may still recommend you a longer stay depending on your post-operative condition.
    With AMIS, the skin incision is often shorter than  with “conventional” surgery and therefore scar tissue is reduced.
    The AMIS technique allows you to return to daily activities in a shorter time frame.
  6. LESS BLOOD LOSS [2, 3]
    Preservation of muscles and vessels potentially reduces blood loss. Transfusions are rare, blood clots in the legs (deep venous thrombosis) are potentially less likely.
  7. REDUCED RISK OF DISLOCATION (separation of the hip ball and socket) [4, 8]
    As a result of  the AMIS technique the preservation of muscles significantly improves the stability of the hip. The risk of dislocation is minimal and the post-operative limitation of movements, usually prescribed in other techniques, is not necessary. The risk of dislocation is reduced because the anterior approach is performed from the front of your body and dislocation is mainly related to posterior hip structure damage.
  8. PREVENTION OF LIMPING [9, 10, 11, 12]
    AMIS is characterised by a surgical technique that protects the various muscles, blood vessels and nerves encountered during exposure of the hip joint. Minimizing muscle and nerve damage reduces the chances of limping.

[1] Arthroplastie totale de hanche par voie antérieure et son évolution mini-invasive; F. Laude et al.; EMC; 2004, 44-667-B
[2] Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24
[3] Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9
[4] Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res, 2004 Sep, (426): 164-73
[5] What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46
[6] Rapid Rehabilitation and recovery with minimally invasive total hip arthroplasty; RA Berger et al; Clin Orthop Relat Res, 2004, (429): 239-247
[7] The minimally invasive anterior approach to hip arthroplasty; RE Kennon et al; Orthopäde, 2006 Jul, 35 (7): 731-7
[8] Dislocation after hip hemiarthroplasty: anterior versus posterior capsular approach.; JB Bush et al; Orthopedics. 2007 Feb;30(2):138-44
[9] Muscular damage after total hip arthroplasty: conventional versus minimally invasive anterior approach.;  Dr Dora, Dr Kalberer; AOA 2008, Australia, Hobart
[10] Abductor Tendons and Muscles Assessed at MR Imaging after Total Hip Arthroplasty in Asymptomatic and Symptomatic Patients. C. Pfirmann et al., Radiology 2005, 235: 969-976.
[11] MR imaging of the abductor tendons and muscles after total hip replacement in asymptomatic and symptomatic patients. PD Dr. Dora, EFORT 2007
[12] Der anteriore Zugang für die minimal-invasive HTEP. C Dora; Leading Opinions Sept 2006, 1/2006