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A new approach to the hip for revision surgery
D J McMinn1, P Roberts, G R Forward
1Royal Orthopaedic Hospital, Northfield, Birmingham, England.
The Journal of Bone and Joint Surgery. British Volume
|November 1, 1991
Summary
This study introduces a novel V-shaped flap for hip revision surgery, improving surgical exposure without trochanteric osteotomy. This technique allows for adjustable abductor tension during complex hip reconstructions.
Area of Science:
- Orthopedic Surgery
- Hip Reconstruction
- Surgical Techniques
Background:
- Difficult hip revision surgeries often require extensive exposure.
- Traditional methods like trochanteric osteotomy can lead to complications.
- Improved surgical access is crucial for complex hip procedures.
Purpose of the Study:
- To describe a new surgical approach for hip revision surgery.
- To provide enhanced exposure for challenging cases.
- To avoid the need for trochanteric osteotomy.
Main Methods:
- A V-shaped myofascial flap is utilized, incorporating vastus lateralis, gluteus medius, and minimus.
- The flap is reflected off the greater trochanter and proximal femur.
- This provides access to the entire hip capsule.
Main Results:
- The described V-shaped flap technique allows for improved visualization of the hip joint.
- It facilitates complex revision procedures without trochanteric osteotomy.
- Abductor tension can be adjusted post-operatively using a V-Y plasty principle for leg length discrepancies.
Conclusions:
- This novel V-shaped flap offers a viable alternative for hip revision surgery.
- It enhances surgical exposure and simplifies management of abductor tension.
- The technique is particularly beneficial for difficult revision cases requiring significant femoral lengthening.