Posterior Approach by Dr. Bose

Summary of Advantages - Posterior vs. Anterior Approach: ...The posterior approach for hip resurfacing has the following advantages now that the instrumentation has been redesigned specifically for that approach: 1. No important muscle groups are sectioned. 2. There is no release of the abductor muscles. They are the most important muscles stabilizing the hip during walking and other activities. 3. The gluteus medius and minimus remain intact. The only muscle groups that are released are the short rotators that are repaired at the conclusion of the procedure. However, no important gait or other disturbances results from a release even if they are not repaired because the rotation is accomplished by other muscles. One of the two insertions of the gluteus maximus tendon which extends the hip may be released and if so then repaired. The other insertion remains intact and there has been no significant physiological damage to date. 4. The new instrumentation facilitates a smaller incision especially in thin individuals. A longer incision is necessary in well muscled or overweight patients. A slightly longer incision is necessary in resurfacing than when the head and neck are amputated in conventional THR. In hip resurfacing the surgeon must work around the head and neck to be able to prepare the acetabulum and implant the socket accurately. Hip resurfacing is technically more demanding and takes slightly longer. Since hip resurfacing is an anatomical replacement, leg length equalization is facilitated and more precise. Leg length equalization in THR is more demanding, less certain and requires an intra-operative X-ray. 5. The anterior approach requires removal of some of the abductor muscles for either hip resurfacing or THR. Even though they are repaired this reattachment may not be 100% successful... READ MORE