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Approaches to the Hip: Minimally Invasive Postero Lateral Total Hip Arthroplasty

February 01, 2014

Contributors: Francesco Traina, MD, PhD; Mohammadreza Chehrassan, MD; Raffaele Borghi, MD; Daniele Fabbri, MD; Matteo Nanni, MD; Federico Pilla, MD; Marco Pedrini, MD; Sandro Giannini, MD; Cesare Faldini, MD; Cesare Faldini, MD

This video shows the surgical technique of modified minimally invasive posterolateral total hip arthroplasty (THA). THA can be safely performed through a number of surgical approaches. The posterior approach first was described by Kocher and Langenbeck and then popularized by Moor as the “the southern approach.”Through detachment of the short external rotators, this approach allows good acetabular and femoral visualization with low postoperative functional hip impairment, thanks to the integrity of the abductor muscles. Moreover, this approach can be performed with fewer assistants. However, the higher incidence of implant dislocation and sciatic nerve palsy and poor leg length control during surgery are associated disadvantages. The modified minimally invasive posterolateral approach appears to be better than the traditional posterior THA approach in terms of early patient function and scar acceptance, with lower postoperative complications. Technically, this approach entails gluteus maximus splitting and cutting the short external rotators in association with capsular sparing to allow soft-tissue reattachment at the end of the procedure to reduce posterior dislocation chance. Our results with this surgical technique suggests that good soft-tissue reattachment following the modified minimally invasive posterolateral approach greatly diminishes the postoperative dislocation rate and provides acceptable postoperative stability. The approach provides excellent exposure for surgeons and their assistants and helps them achieve accurate placement of components in an efficient manner. This approach is rapid and reproducible, and allows performance of THA with a low percentage of blood loss and an acceptable hospital length of stay.

Results for "Physical Exam/Anatomy"


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