A modified lateroanterior approach in operations for hip arthroplasty

When straight and bulky instruments are used in operations for hip arthroplasty, exposure of the hip is not always wide enough, and extensive tissue dissection or a trochanteric osteotomy may be necessary. To avoid this and yet obtain wide exposure, a modified lateroanterior Ling approach was used in 40 consecutive operations for hip arthroplasty. The continuity between the gluteus medius and the vastus lateralis is preserved. These muscles are split, and the anterior attachments are decorticated from the greater trochanter, forming an osteotendinous flap that is displaced ventrally, exposing the anterior capsule of the hip. This approach, causing the least disturbance to the abductor mechanism, offers the advantages of wide exposure and, postoperation, a stable and easily activated hip.