Modified Posterior Approach to Total Hip Arthroplasty to Enhance Joint Stability

We modified the posterior approach by preserving the external rotator muscles to enhance joint stability after primary THA. We asked whether this modified posterior approach would have a lower dislocation rate than the conventional posterior approach, with and without a repair of external rotator mu...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2008-02, Vol.466 (2), p.294-299
Main Authors: Kim, Yong Sik, Kwon, Soon Yong, Sun, Doo Hoon, Han, Suk Ku, Maloney, William J.
Format: Article
Language:English
Subjects:
Adult
Arthroplasty, Replacement, Hip - methods
Biological and medical sciences
Conservative Orthopedics
Diseases of the osteoarticular system
Female
Hip Dislocation - prevention & control
Hip Injuries - surgery
Hip Joint - physiopathology
Hip Joint - surgery
Humans
International Hip Society Symposium
Joint Instability - prevention & control
Joint surgery
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Muscle, Skeletal - surgery
Orthopedic surgery
Orthopedics
Postoperative Complications - prevention & control
Retrospective Studies
Sports Medicine
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical Orthopedics
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Summary:We modified the posterior approach by preserving the external rotator muscles to enhance joint stability after primary THA. We asked whether this modified posterior approach would have a lower dislocation rate than the conventional posterior approach, with and without a repair of external rotator muscles. We retrospectively divided 557 patients (670 hips) who had undergone primary THA into three groups based on how the external rotator muscles had been treated during surgery: (1) not repaired after sectioning, (2) repaired after sectioning, or (3) not sectioned and preserved. The minimum followup was 1 year. In the group with preserved external rotator muscles, we observed no dislocations; in comparison, the dislocation rates for the repaired rotator group and the no-repair group were 3.9% and 5.3%, respectively. This modified posterior approach, which preserves the short external rotator muscles, seemed effective in preventing early dislocation after primary THA. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-007-0056-8