Posterior Mini-Incision Approach for Total Hip Replacement

JBJS Essential Surgical Techniques
Lawrence D Dorr

Abstract

We developed a modification of the posterior mini-incision for total hip arthroplasty, which was initially used by Sculco at The Hospital for Special Surgery, in response to the movement in the orthopaedic community to perform total hip arthroplasty with smaller incisions. Our approach preserves the piriformis and quadratus femoris muscles of the external rotators, uses three incisions into the capsule but does not excise the capsule, does not incise the tensor fascia/iliotibial band, and leaves intact the insertion of the gluteus maximus onto the femur. We have used this incision since 2004, and our published results and those of others show that the greatest advantage is cosmetic and patients' perception of less violation of their body. It is a contributor to the same-day surgery program and rapid recovery protocol on which we have reported. The steps of the procedure include (1) an incision made along the posterior edge of the greater trochanter from the level of the vastus tubercle to one fingerbreadth from the tip of the greater trochanter; (2) a deep L-shaped incision parallel to the piriformis tendon, and along the posterior edge of the greater trochanter through the small external rotator muscles and hip capsule to the ...Continue Reading

References

Dec 7, 2005·Clinical Orthopaedics and Related Research·Yutaka InabaMyriam Boutary
Oct 13, 2006·Clinical Orthopaedics and Related Research·Aditya Vikram MaheshwariLawrence D Dorr
Jan 17, 2007·Clinical Orthopaedics and Related Research·Lawrence D DorrLeigh E Sirianni
Jun 5, 2007·The Journal of Bone and Joint Surgery. American Volume·Lawrence D DorrLeigh Ellen Sirianni
Jul 31, 2009·The Journal of Arthroplasty·Lawrence D DorrWilliam T Long
Aug 2, 2014·Clinical Orthopaedics and Related Research·Kirsten L Poehling-MonaghanMark W Pagnano

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Citations

Jul 18, 2020·International Orthopaedics·Mokrane Ait Mokhtar

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