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Modified Posterior Approach to Total Hip Arthroplasty to Enhance Joint Stability

  • International Hip Society Symposium
  • Published:
Clinical Orthopaedics and Related Research

Abstract

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.

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Acknowledgments

We thank Katharine O’Moore-Klopf and Eun-Na Choe for providing editorial assistance.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kang-Nam St. Mary’s Hospital, The Catholic University of Korea, Banpo-Dong 505, Seocho-Gu, Seoul, 137-040, Korea

    Yong Sik Kim MD

  2. Department of Orthopaedic Surgery, St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea

    Soon Yong Kwon MD

  3. Department of Orthopaedic Surgery, Sun Hospital, Daejeon, Korea

    Doo Hoon Sun MD

  4. Department of Orthopaedic Surgery, St. Paul’s Hospital, The Catholic University of Korea, Seoul, Korea

    Suk Ku Han MD

  5. Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, CA, USA

    William J. Maloney MD

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  1. Yong Sik Kim MD
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  2. Soon Yong Kwon MD
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  3. Doo Hoon Sun MD
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  4. Suk Ku Han MD
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  5. William J. Maloney MD
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Corresponding author

Correspondence to Yong Sik Kim MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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

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Kim, Y.S., Kwon, S.Y., Sun, D.H. et al. Modified Posterior Approach to Total Hip Arthroplasty to Enhance Joint Stability. Clin Orthop Relat Res 466, 294–299 (2008). https://doi.org/10.1007/s11999-007-0056-8

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  • DOI: https://doi.org/10.1007/s11999-007-0056-8

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