AN ANTEROLATERAL APPROACH TO THE HIP-JOINT

I describe an anterolateral approach to the hip joint. The intermuscul ar plane is between the gluteus medius and tensor fascia lata. The ant erior one third of gluteus medius and the insertion of gluteus minimus are stripped from the anterior aspect of the greater trochanter to ra ise a flap in a way that facilitates reattachment. The vastus laterali s muscle is left undisturbed. This simple and relatively quick approac h provides sufficient anatomic orientation and exposure to allow the s urgeon to perform total hip arthroplasty, with minimal dissection and without excessive retraction. There is no danger of injury to the supe rior gluteal nerve or its branches. This has been used in 178 patients for primary total hip replacement. The strength of the hip abductor m uscles was unimpaired and there were no complications attributable to the approach in 128 patients reviewed after at least 6 months.