Abstract
Aim: The direct lateral approach, as described by Hardinge et al, may have the advantage of reducing the incidence of dislocation after total hip arthroplasty. The purpose of this paper is to describe a modification of the direct lateral approach used by the author on consecutive total hip arthroplasty for all patients; including primary arthritis, fractures and revisions over a period of five years. The incidence and causes of complications, specifically dislocation, is discussed.
Method: A modification of the direct lateral approach, where gluteus minimus is split anteriorly rather than being detached from the greater trochanter, is described. This approach allowed its primary repair during wound closure, reducing surgical dead-space and theoretically reducing the incidence of dislocation. The records of all patients in whom the author performed this approach for total hip arthroplasty between 1 February 1994 and 1 February 1999 were examined. Patients were routinely seen at one year after operation and any early complications of surgery recorded. Minimum follow-up for this series was one year.
Conclusion: This modification of the direct lateral approach which preserves the integrity of gluteus minimus while still allowing adequate exposure and is extensile, gave a very acceptable incidence of dislocation in total hip arthroplasty for degenerative disease, fracture, and revision cases.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
