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Surgical Technique: A Simple Soft-tissue-only Repair of the Capsule and External Rotators in Posterior-approach THA

  • Symposium: Papers Presented at the Annual Meetings of The Hip Society
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Clinical Orthopaedics and Related Research®



Posterior soft tissue repair after posterior THA reportedly decreases the risk of dislocation. Previously described techniques often require drill holes through the greater trochanter, do not include both the short external rotators and the capsule, or require a complex series of multiple sutures. We therefore describe a technique to address these issues.

Description of Technique

The posterior soft tissues were repaired with a single nonabsorbable suture passed through the external rotators and posterior capsule and then through the capsule and posterior border of minimus in a figure-of-eight pattern. This repair remains pliable and obliterates the dead space.


We retrospectively reviewed 165 patients who underwent 178 primary THAs through a mini-posterior THA and also underwent soft tissue repair using our technique. We determined the rate of dislocation and complications associated with this technique. The minimum clinical followup was 1 year (mean, 23 months; range, 12–37 months).


This repair was associated with a low risk of dislocation at 1 year (one of 178 hips, 0.56%) and no apparent complications related to the technique.


This soft tissue to soft tissue repair technique after posterior-approach THA is technically straightforward and reliable with a low associated dislocation rate.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations


Corresponding author

Correspondence to James A. Browne MD.

Additional information

One of the authors (MWP) has received royalties from DePuy Orthopaedics Inc (Warsaw, IN, USA), MAKO Surgical Corp (Fort Lauderdale, FL, USA), Stryker Orthopaedics (Mahwah, NJ, USA), and Zimmer Inc (Warsaw, IN, USA).

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Mayo Clinic.

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Browne, J.A., Pagnano, M.W. Surgical Technique: A Simple Soft-tissue-only Repair of the Capsule and External Rotators in Posterior-approach THA. Clin Orthop Relat Res 470, 511–515 (2012).

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