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ABLE Approach


The ABLE Advanced Anterior Approach is a minimally invasive, muscle-sparing approach with no barriers to adoption, complementing a value-based system of limiting healthcare dollar spend while maintaining or improving patient outcomes. 

This surgical approach to the hip joint was first described by Sayre in 1854 who utilized the Tensor Fasciae Lata (TFL)/Gluteus medius interval for the treatment of septic hip arthritis in a 9-year old patient.1  The surgical approach has since been modified, first by Watson-Jones2 and more recently by Bertin and Rottinger3 who placed the patient in the lateral decubitus position with the surgeon standing in front of the patient. This intermuscular interval through a small incision provides good exposure for THA: it preserves muscle integrity facilitating rapid rehabilitation and, with the posterior capsule remaining intact, posterior dislocation rates are greatly reduced.4

  • Utilizes the Tensor Fasciae Lata (TFL)/Gluteus Medius Interval
  • Can be performed in the supine or lateral position and allows the surgeon to transition to the surgical approach with which they feel most comfortable
  • Minimal investment required – a pegboard (for lateral approach), standard Innomed retractors and S+N implants like R3, ANTHOLOGY AFIT and POLARSTEM
  • A large retrospective analysis (n=6,251) has shown the ABLE Advanced Anterior Approach to be efficient and effective with minimal complications, good outcomes and high patient satisfaction5

Benefits of the ABLE Advanced Anterior Approach5

Blood loss management

As an alternative to tourniquets or monopolar electrocautery, the WEREWOLF FASTSEAL 6.0 Hemostasis Wand facilitates hemostasis in soft-tissue and bone using biopolar radio frequency (RF) technology. With auxiliary control allowing immediate access to maximum power and flow settings when required, it offers precision powered performance while setting a new standard in value.

Find out more

  1. Sayre LA. Exsection of the head of the femur, and removal of the upper rim of the acetabulum, for morbus coxarius. New York: Holman, Gray & Co.; 1854.
  2. Watson‐Jones, R. Fractures of the neck of the femur. British Journal of Surgery. 1936;23:787-808.
  3. Bertin, KC, Röttinger, H. Anterolateral mini-incision hip replacement surgery: a modified Watson-Jones approach. Clin Orthop Relat Res. 2004;248–255.
  4. Hansen BJ, Hallows RK, Kelley SS. The Rottinger approach for total hip arthroplasty: technique and review of the literature. Curr Rev Musculoskelet Med. 2011;4:132-138.
  5. Smith+Nephew. The ABLE◊ (advanced anterior approach): a retrospective case series. Clinical and Medical Affairs Evidence Outcomes Report. Published internal document. 2021. EO.REC.PCSgen.001.v1.