Anterior PATH (Portal Assisted Total Hip)
Anterior PATH is an evolution on the anterior total hip. It can be thought of as an improvement and advancement over standard direct anterior hip replacement. Dr. Assini and a team of 5 other surgeons in the US and Canada have designed this technique and invented the instrumentation that allows them to perform total hip arthroplasty with all the benefits of anterior total hip, but without the downsides.
Anterior hip replacement has been around for nearly 25 years and has been commonplace for the past 10-15 years. While it is a great approach for hip replacement some patients may experience issues with wound healing, nerve pain/numbness and component malalignment. Typically, issues are caused by poor wound placement and subsequent poor visualization. To combat this, AnteriorPATH moves the incision to the patients’s groin where the incision is smaller, heals quicker and uses the portal to maintain precise component positioning with optimal visualization and virtually no soft tissue disruption.
Nearly all patients that are candidates for an anterior total hip can be treated with this new technique. For Dr. Assini’s practice, this means over 95% of his total hips will be done via the AnteriorPATH.
About the Technique
AnteriorPATH uses a newly designed instrument to place a cannula (think of a BIC pen) through a small 1cm incision on the patient’s thigh. The cannula is then used as a portal to the hip joint joint. This in turn allows Dr. Assini to move the surgical incision into a more favorable location in the groin. The ‘bikini’ incision is located in the flexion crease of the groin and is known to heal more readily, reduce nerve injury and allows better visualization for component placement. A faster healing incision reduces infection risk and better component placement leads to improved pain relief and joint function.
AnteriorPATH was introduced in 2019 and is an important step forward in total hip evolution. Dr. Assini and the other surgeon designers are completing a Multicenter Trial to quantify and publish the benefits for patients.