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We have used different stems (straight, anatomical, modular and short) and press fit acetabularcup with polyethylene or ceramic insert and we have always used 36 mm femoral heads whenallowed by the cup dimensions. We have used any size both of stems and cups withoutlimitation due to the surgical approach.The mean age is 61.8 y.o., 324 females and 176 males.Obese patients, hip dysplasia Crowe 3 and 4 and post traumatic arthrosis are exclusion factorsfor the execution of this approach. If possible we have maintained the capsulo-tendinous lessinvasivity. The BMI is not an excluding factor because it’s just the gluteus region that is animportant factor to decide if to execute or not a less invasive approach.Analyzing our 500 cases we didn’t have any case of malpositioning of the stem in varus orvalgus (more than 5°) and considering acetabular cup we had the tendency to position it invalgus position (not more than 40°) in the first 20 cases.No leg discrepancy more than 1 cm were observed.Intra-operative blood loss have been reduced of about 30 % and 50% in the post-operative.All the patients were able to active hip mobilization within the first day after surgery with amean range of motion of 0-70°.The patients were mobilized the first day after surgery and 80% of them were able to assistedwalk within second day after surgery.The mean time of stay in hospital was 6.8 days.After 4 weeks 98% of the patients were able to walk without crutches.One case of deep infection were evaluated and then solved with surgical debridement; nowound dehiscence.We had 1 case of anterior hip dislocation in dysplastic arthrosis due to a technical mistake.In 1 case we had femoral nerve palsy, then solved, probably because of anterior retractormalpositioning.We had 5 cases of piriformis muscle contracture without sciatic nerve palsy, then solved.We think that for total hip replacement this conservative postero-lateral approach, thanks tocapsule-tendinous modification we have adopted, could be considered an anatomical approach,which doesn’t present more dislocation risks compared to other approaches to the hip alsothanks to the introduction of 36 mm femoral head that gives more stability andproprioceptiveness.Besides this approach gives the possibility of a shorter rehabilitation as seen above and it couldbe consider optimal for total hip replacement.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]