J Korean Hip Soc.  2011 Sep;23(3):165-168. 10.5371/jkhs.2011.23.3.165.

Modified Posterior Approach to Total Hip Arthroplasty

• Sun DH

• KMID: 2014881
• DOI: http://doi.org/10.5371/jkhs.2011.23.3.165

Abstract

This paper reviews the posterior approach to total hip arthroplasty and introduces the modified short external rotator muscle saving posterior approach, which enhances hip stability after total hip replacement arthroplasty. In total hip replacement arthroplasty, dislocation is the most common early complication. Especially in the posterior approach, dislocation is more common than in the anterior or lateral approach to the hip. However, preservation or meticulous repair of the short rotator could reduce the incidence of posterior hip dislocation after total hip replacement arthroplasty. With a brief review of the posterior approach to the hip, we introduce the short external rotater muscle saving modified posterior approach to total hip arthroplasty.

Keyword

Posterior approach; Hip joint; Short external rotator muscle saving

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip
Dislocations
Hip
Hip Dislocation
Hip Joint
Incidence
Muscles

Figure

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  Fig. 1 Skin incisions. (A) Henry's question mark incision. (B) Gibsion incision. (C) Kocher-Langenbeck incision. (D) Moor incision.

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  Fig. 2 (A) Excision Site of short external Rotator muscles at insertion on posterior femur. (B) Superior gluteal nerve innervates abductor muscles. (C) Sciatic nerve should be protected while retracing the soft tissue.

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  Fig. 3 (A & E) Pyriformis & Obturator internus muscles: origins are very huge. (B, C & D) Superior gemeli, Inferior gemeli & Quadratus femoris muscles.

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  Fig. 4 Inferior gemeli and Obturator muscles are excised as dotted line to reach posterior joint capsule.

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