High preservation rates of the ascending branch of the lateral femoral circumflex artery during total hip arthroplasty through the direct anterior approach.

Purpose: (i) To investigate the rate of preservation of the ascending branch of the lateral femoral circumflex artery (a-LFCA) during total hip arthroplasty (THA) through a direct anterior approach (DAA), and (ii) to study factors that contribute to its successful preservation. Methods: All patients who underwent primary THA between 1 September 2023 and 29 February 2024 were reviewed. One-hundred seventy-two patients were included in the study, 91 females and 81 males, aged 63.2 ± 12.6, with a body mass index of 26.1 ± 4.6 kg/m Results: The a-LFCA was preserved in 130 patients (75.6%), had to be ligated/electrocauterized due to obstruction of the surgical field during dissection in 31 patients (18.0%), and had to be electrocauterized due to bleeding during femoral broaching or stem insertion in 11 patients (6.4%). Multivariable logistic regression analyses revealed that preservation of a-LFCA was significantly more likely in female patients (odds ratio [OR] = 2.22; 95% confidence interval [CI] = 1.1-4.6; Conclusions: Preservation of the a-LFCA is possible in the majority of patients (75.6%) undergoing THA through minimally invasive DAA. Furthermore, preservation of the a-LFCA is more likely in female patients, younger patients and patients with lower weight. Level of Evidence: Level IV.