The Superior Transverse Anatomic Reconstruction (STAR) approach is a hip replacement surgery technique that preserves the piriformis muscle and anatomically repairs the capsule and obturator internus, allowing for less trauma than conventional approaches while protecting neurovascular structures. The STAR approach is a straightforward surgical approach requiring minimal additional training and can be performed with standard instrumentation without traction or radiography.
S - Superior to the vastus ridge
T - Transverse: 45° to the vastus ridge
A - Anatomic: Parallel to Langer's lines and gluteal fibers; piriformis preservation
R - Reconstruction: Anatomic reconstruction of capsule and SER
Minimally invasive surgery focusing on incision placement and piriformis preservation THA were concepts explored by Thomas Sculco, MD and Lawrence Dorr, MD, respectively, in the early 2000s.
The STAR approach was invented in 2019 by Eleftherios Tsiridis, MD, Chairman of Orthopaedic Surgery at the Aristotle University Medical School at PGH Hospital in Thessaloniki, Greece. Inspired by Dr. Tsiridis' dual practice in hip reconstruction and pelvic trauma, the STAR approach is an evolution of these prior minimally invasive techniques.
Since STAR was first published in European literature in 2021, its increasing adoption has been evident across the globe. Peter Sculco, MD, an orthopaedic surgeon at the Hospital for Special Surgery in New York City, was the first to recognize its value and implement the STAR approach in his practice.
Collaborating closely, the two surgeons co-founded the STAR Approach Foundation last year with a unified vision: to enhance outcomes for patients undergoing hip arthroplasty by educating surgeons worldwide and publishing high-quality academic research.
The STAR Approach Foundation is a non-profit organization dedicated to improving clinical outcomes of patients undergoing hip replacement surgery using a piriformis-preserving approach. The foundation focuses on education, research, and surgical innovation.
The STAR Foundation believes in the value of the STAR Approach and what it offers to patients, surgeons, allied professionals, and health care systems.
The STAR Foundation and its members will continue to share best practice principles for surgeons, disseminate the highest quality information to patients and providers, and empower them to make informed decisions on surgical approaches for hip replacement surgery.
PROMOTE awareness of the STAR approach
EDUCATE residents, fellows, and surgeons on its techniques and efficacy
BUILD a global network of surgeons who are interested in piriformis-preserving surgery
FOSTER collaboration with academic institutions and industry to drive surgical innovation
PUBLISH high-quality academic research
ENHANCE patient care and outcomes for those undergoing hip arthroplasty
optimal patient care and improve patient outcomes in the modern era of advanced technologies and rapid recovery.
surgeons worldwide to share advanced skills and clinical experience in piriformis-preserving hip reconstructive surgery.
basic science, translational, and clinical studies.
patients, residents, fellows, orthopedic surgeons, and allied professionals.
instrumentation and enabling technologies to facilitate the STAR approach.
with academic hospitals and industry.
the STAR approach worldwide through webinars, social media platforms, and our website.
and organize an international STAR arthroplasty registry.
The STAR Approach Foundation members represent a well-accomplished group of surgeons from around the world with a track record of high-volume surgical practices and published research. All members have committed to advancing the STAR Foundation and the field of total hip arthroplasty.
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