Repair of the Released Conjoined Tendon After Direct Anterior Total Hip Arthroplasty

Release of the conjoined tendon has been reported to facilitate femoral exposure during a direct anterior hip approach. However, the authors are not familiar with any description of an anterior approach repair technique for this important structure. Conjoined tendon repair is commonly performed in the posterior approach to help preserve hip biomechanics and restore anatomic tissue planes. The authors describe their algorithm for sequential soft tissue releases to facilitate femoral exposure and a technique for repairing the insertion of the conjoined tendon after it has been released for exposure during the direct anterior approach.