Total hip arthroplasty with a superior approach and in situ preparation of the femoral stem: technique and feasibility in a prospective series of 80 cases


hip; approach; superior; arthroplasty; replacement

Published online: May 03 2022

Wouter Sioen, Tom Lattré, Steven Parmentier, Kurt Claeys

From the Department of Orthopaedic Surgery, OLV Ziekenhuis, Waregem, Belgium


We report on the feasibility of a technique for total hip replacement with in situ preparation of the femoral stem through a superior approach and with the use of standard instruments.

From December 2017 to august 2018, 100 patients were recruited for total hip replacement. 80 patients underwent THA through a superior approach with femoral broaching before femoral neck cut. We evaluated feasibility, complications and early functional outcome.

There were no major complications. Postoperative leg length discrepancy was on average +0.6mm and offset -0.5mm. The mean acetabular cup inclination was 42.0° and the mean anteversion was 14.5°. The mean WOMAC score was 46 before, 76 at 1 month and 86 at 3 months after surgery. Functional scores (OARSI) were significantly improved at 3 months. Superior in situ total hip replacement is a reliable and reproducible technique with an excellent clinical outcome. It is an iteration to the posterior approach, hence the learning curve is steep and if needed, conversion to a standard posterior approach is possible.