The Anatomic-Atraumatic-Anterior Reconstructive Technique (A-A-ART) for total hip arthroplasty: A step-by-step pictorial guide to a minimally invasive approach for hip osteoarthritis.
5 affiliations
- 1Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, Lyon, France - Department of Orthopaedics Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France - Department of Orthopaedic Surgery, St. Luke's Hospital, 55236 Panorama-Thessaloniki, Greece.
- 2Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, Lyon, France.
- 3Department of Orthopaedic Surgery, Bioclinic, 54622 Thessaloniki, Greece.
- 4Department of Orthopaedic Surgery, St. Luke's Hospital, 55236 Panorama-Thessaloniki, Greece.
- 5Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, Lyon, France - Department of Orthopaedics Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France.
Abstract
Total hip arthroplasty remains one of the most successful orthopedic procedures for the treatment of hip osteoarthritis. Among contemporary surgical approaches, the direct anterior approach has gained increasing popularity due to its intermuscular and internervous plane, which aims to minimize soft-tissue trauma and potentially reduce instability. This article provides a step-by-step pictorial overview of the Anatomic-Atraumatic-Anterior Reconstructive Technique (A-A-ART) performed without a traction table and combined with dual-mobility articulation. Key technical steps are described, including patient positioning, capsular management, acetabular preparation using anatomical landmarks, controlled femoral exposure, and implant positioning. Particular emphasis is placed on progressive capsular release, protection of the anterior acetabular horn, and prevention of varus stem alignment. When performed in a standardized and reproducible manner, the A-A-ART technique allows reliable limb length control, stable component orientation, and preservation of periarticular structures, offering a safe and effective strategy for the surgical management of hip osteoarthritis.
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BibTeX
@article{vasiliadis2026anatomicatraumaticanterior,
title = {{The Anatomic-Atraumatic-Anterior Reconstructive Technique (A-A-ART) for total hip arthroplasty: A step-by-step pictorial guide to a minimally invasive approach for hip osteoarthritis.}},
author = {Angelo V Vasiliadis and Vasileios Giovanoulis and Rigas Santas and Theofilos Dimitriadis and Cécile Batailler and Sébastien Lustig},
journal = {SICOT-J},
year = {2026},
month = oct,
doi = {10.1051/sicotj/2026071},
url = {https://europepmc.org/article/MED/42932859},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Anatomic-Atraumatic-Anterior Reconstructive Technique (A-A-ART) for total hip arthroplasty: A step-by-step pictorial guide to a minimally invasive approach for hip osteoarthritis.
AU - Angelo V Vasiliadis
AU - Vasileios Giovanoulis
AU - Rigas Santas
AU - Theofilos Dimitriadis
AU - Cécile Batailler
AU - Sébastien Lustig
PY - 2026
DA - 2026/10/26
JO - SICOT-J
DO - 10.1051/sicotj/2026071
UR - https://europepmc.org/article/MED/42932859
AB - Total hip arthroplasty remains one of the most successful orthopedic procedures for the treatment of hip osteoarthritis. Among contemporary surgical approaches, the direct anterior approach has gained increasing popularity due to its intermuscular and internervous plane, which aims to minimize soft-tissue trauma and potentially reduce instability. This article provides a step-by-step pictorial overview of the Anatomic-Atraumatic-Anterior Reconstructive Technique (A-A-ART) performed without a traction table and combined with dual-mobility articulation. Key technical steps are described, including patient positioning, capsular management, acetabular preparation using anatomical landmarks, controlled femoral exposure, and implant positioning. Particular emphasis is placed on progressive capsular release, protection of the anterior acetabular horn, and prevention of varus stem alignment. When performed in a standardized and reproducible manner, the A-A-ART technique allows reliable limb length control, stable component orientation, and preservation of periarticular structures, offering a safe and effective strategy for the surgical management of hip osteoarthritis.
SN - 2426-8887
ER -