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Chapter 06 Video 1: Anterior Based Muscle Sparing Approach to the Hip

November 07, 2016

Contributors: Johannes F Plate, MD, PhD; Thorsten M Seyler, MD, PhD; James Messersmith, PA-C; Rhett Hallows, MD; Scott S Kelley, MD

In recent years, the direct anterior approach has gained in popularity, arguably in response to device companies’ direct-to-consumer marketing efforts of new implant designs and subsequent patient demands. Watson-Jones described a surgical interval to expose femoral neck fractures but never described a surgical approach to the hip joint. Based on the classic Watson-Jones muscle interval, Bertin and Rottinger initially described an anterior-based muscle-sparing approach (ABMS) without detachment of the adductor muscles. While it is similar in many respects to the direct anterior approach, it utilizes a standard operating room table and has the following advantages over the direct anterior approach: it is extensile, no weight/BMI limitation, inexpensive operating room table, fluoroscopy optional, can be performed supine or lateral decubitus position, ability to perform range of motion testing, and most importantly allows the surgeon to any implant design, including reamed-based and cemented implants. There a few contraindications known for the ABMS approach. As with any muscle sparing approach to THA, there is both enthusiasm and concern. This is a technically demanding approach and access to the posterior acetabular wall for hardware removal, posterior wall bone grafting should be considered relative contraindications for using this approach. The ABMS approach is associated with a learning curve and the authors recommend practicing the approach on cadaveric specimen and surgeon visitation prior to clinical implementation.

Results for "Advanced Reconstruction Hip 2"