Description
In this presentation, Andrew Thomas discusses the anterolateral approach to hip surgery, referencing classical anatomical illustrations by Vesalius and Leonardo da Vinci for anatomical context. He contrasts this approach with the posterior approach, highlighting the advantages of the lateral view and the thoughtful nature of its anatomical arrangement. Thomas details a modified version of the anterolateral technique first used by Mike Freeman, emphasizing its differences from the direct lateral approach popularized by Kevin Hardinge, notably in how the gluteus medius and minimus are handled.
He explains the surgical process, including the crucial steps of detaching the anterior third of the gluteus medius and the importance of maintaining a limit to avoid nerve injury. The presentation goes on to cover dissection techniques and the need to cut the posterior capsule to achieve optimal exposure, especially in patients with osteoarthritis, adding critical information about handling soft tissue with minimal trauma.
Thomas shares his insights on closing the surgical incision and offers tips for patient positioning and incision length, underscoring that larger incisions can ultimately lead to better outcomes. He reviews outcomes data for his approach, noting a low revision rate and favorable patient-reported outcomes, concluding that while the posterior approach has its advantages for certain cases, the anterolateral approach is both safe and reliable, providing exciting opportunities for surgical intervention.