Surgical nuances to minimize muscle damage during the direct lateral approach in minimally invasive hip replacement.

Compared with total hip replacements performed using a standard incision direct lateral approach, a minimally invasive direct lateral approach can produce less pain and blood loss without increasing the rate of complications. To minimize the potential for limping after detaching the anterior gluteus medius and the gluteus minimus tendons, special handling of the abductors (which is more difficult because of the limited exposure afforded by the smaller incision) is required. Using special retractors, minimizing overzealous retraction, and achieving strong repair has resulted in no increase in the incidence of limping.