STAR Approach for Conversion THA

Description

The video details a surgical procedure focused on a posterolateral approach for hip intervention, specifically utilizing a STAR approach that preserves the piriformis muscle. The session begins with the surgical team making a careful incision and navigating through layers of subcutaneous fat and fascia to expose deeper structures surrounding the femoral head and greater trochanter.



Key moments include the identification and preservation of important anatomical landmarks such as the piriformis tendon, which is critical for the surgical approach. The surgeon employs various tools like the Hibbs and Charnley retractors for proper visibility and access while also utilizing a Bovie cautery for cutting and mobilization of soft tissues. Through meticulous dissection techniques, the surgeon creates a blunt plane and navigates around the considerable soft tissue structures:



1. **Exposing the Piriformis Muscle:** The surgeon carefully dissects to reveal and preserve the piriformis muscle while avoiding damage to surrounding ligaments and tendons.



2. **Chondroid Tendon Release:** Attention is given to mobilizing the chondroid tendon from the surrounding capsule to ensure proper placement of sutures for later repair.



3. **Capsule Tagging and Repair:** Specific sutures are utilized to tag the superior and inferior aspects of the capsule, ensuring that structures remain aligned for optimal healing post-surgery.



4. **Dislocating the Hip:** Critical instructions are provided regarding the importance of dislocating and then repositioning the hip joint before nail removal, to reduce stress on the hip during the procedure.



Throughout the video, the surgeon emphasizes the need for anatomical awareness, the necessity of preserving vital structures like the sciatic nerve, and the importance of careful mobilization to avoid complications. The step-by-step narration paired with visual references provides an insightful look into advanced orthopedic surgical techniques.

Specialties