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Updated: Jul 18, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

Experience with a modified posterior approach to the hip joint. A technical note.

¹Division of Orthopaedic Surgery, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey 17033.

The Journal of Arthroplasty

|March 1, 1991

Summary

This study introduces a modified posterior hip approach for complex hip replacements. This technique offers excellent joint exposure while preserving hip stability and soft tissues.

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Area of Science:

Orthopedic Surgery
Arthroplasty

Background:

Revision and complex primary hip arthroplasty present surgical challenges.
Optimal surgical approaches are crucial for prosthetic stability and patient outcomes.

Purpose of the Study:

To describe a modified posterior hip approach.
To evaluate its applicability in revision and complex primary hip arthroplasty.

Main Methods:

A posterior approach involving osteotomy of the posterior one-third of the greater trochanter.
Posterior reflection of a full-thickness flap including the trochanteric fragment and short external rotators.
Reattachment of the trochanteric fragment with bone screws for closure.

Main Results:

The approach provides excellent exposure of the acetabulum and femoral canal.

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The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Minimal disruption of gluteal muscle insertions and preservation of the majority of the greater trochanter.

Restoration of an intact soft tissue envelope around prosthetic components.

A limited series showed no complications, loss of reduction, or nonunion.

Conclusions:

The modified posterior approach is a viable option for complex hip arthroplasty.
It facilitates excellent surgical exposure while maintaining hip stability.
The technique appears safe and effective with favorable early results.