MODIFIED ANTEROLATERAL SURGICAL APPROACH IN TOTAL HIP REPLACEMENT

In this paper, we have studied the difference between classic Watson Jones anterolateral approach and modified anterolateral approach started in our institution from 2004 y. in group of patients with BMI more then 30 - 412 patients, mean age was 66,5 y., male -157 (38.2%), female - 255 (61,8%). Primary diagnosis were: Idiopathic osteoarthritis - 379 (92%), Rheumatoid ostheoarthritis - 16 (4%), DDH - 12 (3%). All surgeries were performed on supine position. All surgeries were performed by single surgeon. In 321 (78%) of cases modified approach was used. Only uncemented implants from Zimmer-Biomet were used. In our study we conclude that the differences between these two approaches were hip flection, gluteus medius partial detachment and oblique incision of the skin, but these three point makes the approach much more easier to perform because in flexed position M.Gluteus Medius and M. Tensor Fascia Lata are more relaxed and in 4th position oblique incision protects the skin from damage caused by femoral rasp.