Experience with a modified posterior approach to the hip joint: A technical note

Abstract

A modified posterior approach to the hip joint is described with particular applicability, of revision or complex primary hip arthroplasty. The procedure involves osteotomy of the posteroir one-third of the greater trochanter with posterior reflection of a full-thickness flap, consisting of the posterior trochanteric fragment, short extemal rotators, joint capsule, and posterior portion of the gluteus, medius. The approach allows for excellent exposure of the acetbulum and femoral canal, with minimal disruption of the gluteral muscle insertions. The majority of the greater trochanter is left intact, enhancing femoral component stability. Closure is accomplished, by suture of soft tissues and reattachment of the posterior trochanteric fragment with bone screws. An intact soft tissue envelope is thereby restered, around the prosthetic components. A limited clinic series has identified no problem referable to this exposure. No loss of reduction or nonunion has been encountered.