Review: Posterior Soft Tissue Repair in Primary Total Hip Arthroplasty

Excerpt

The posterior approach is the most common approach used in the United States. Its main advantages include (1) less extensive tissue dissection, (2) better visualization of the acetabulum, (3) lower incidence of heterotopic bone formation, and (4) preservation of the abductor mechanism. Historically, the posterior approach in primary total hip arthroplasty (THA) was associated with an increased risk of postoperative dislocation compared to the anterolateral or the transtrochanteric approach [1‐3]. The senior author (P.M.P.) has described a posterior soft tissue repair reattaching the short external rotators and the posterior capsule to the greater trochanter. This repair has subsequently resulted in a significant reduction of the risk of postoperative dislocation [4]. The current review describes the surgical technique used by the senior author and discusses alternative techniques, biomechanical foundations, and the clinical outcome of patients undergoing primary THA thorough a posterior approach with soft tissue repair. …