A technique of extensile exposure for total hip arthroplasty

A technique of trochanteric osteotomy that allows extensile exposure of the hip and wide exposure of the proximal femoral diaphysis for total joint replacement is described. Pathologic conditions of the shaft encountered during arthroplasty can therefore be addressed. The approach is based on the preservation of an intact musculoosseous-muscular sleeve comprised of the gluteus medius, greater trochanter, and vastus lateralis and allows physiologic reconstruction of the hip's soft tissue envelope. This versatile approach is particularly useful in revision surgery and in difficult primary interventions where leg length is adjusted. The surgical technique, indications, and advantages are described. Early clinical results of 90 cases are presented.