Anterior Lateral Decubitus Intermuscolar (ALDI) approach in hip tissue sparing surgery. A modern interpretation of the Smith-Petersen approach.

Abstract

Background: The increasing desire to protect the periarticular structures has led to the need for Tissue Sparing Surgery. The accesses most widely used are the direct-lateral approach and the postero-lateral one, both with patient in lateral decubitus.
Aim: However, these accesses require an incision of tendons and muscles even in their minimally invasive technique, so we looked for an approach that would wholly protect the periarticular structures and allow us not to revise our experience in patient positioning, preparation of the operating field and surgeon’s position during surgery. Our intent was to leave the acquired knowledge unchanged and to preserve unaltered the anatomical landmarks that we had previously identified and consolidated for the correct positioning of the components.