Passing Cerclage Wires Through a Direct Anterior Approach in Total Hip Arthroplasty: Surgical Technique

Passage of cerclage wires, either for prophylactic stability or for intraoperative fracture fixation, is a commonly used technique in total hip arthroplasty. However, the same techniques for wire placement cannot be used regardless of approach. In the direct anterior approach, common methods to pass wires may place the lateral femoral circumflex artery perforators at risk, as well as the proximal and distal neurovascular bundles to the vastus lateralis. We describe a technique for passing cerclage wires with the direct anterior approach that minimizes neurovascular injury.