International Hip Society Symposium

Clinical Orthopaedics and Related Research

, Volume 466, Issue 2, pp 294-299

First online:

Modified Posterior Approach to Total Hip Arthroplasty to Enhance Joint Stability

  • Yong Sik KimAffiliated withDepartment of Orthopaedic Surgery, Kang-Nam St. Mary’s Hospital, The Catholic University of Korea Email author 
  • , Soon Yong KwonAffiliated withDepartment of Orthopaedic Surgery, St. Mary’s Hospital, The Catholic University of Korea
  • , Doo Hoon SunAffiliated withDepartment of Orthopaedic Surgery, Sun Hospital
  • , Suk Ku HanAffiliated withDepartment of Orthopaedic Surgery, St. Paul’s Hospital, The Catholic University of Korea
  • , William J. MaloneyAffiliated withDepartment of Orthopaedic Surgery, Stanford Hospital and Clinics

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


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.