Total Hip Arthroplasty: Posterior Approach

Description

Dr Jonathan Vigdorchik gives his insights as he discusses the posterior approach for total hip arthroplasty (THA) and its historical association with dislocation rates. He notes that in 1978, a 3% dislocation rate was observed, but advancements have reduced this to approximately 1.5% to 2%. A study from 2008 demonstrated that posterior soft tissue repairs significantly heal and reduce dislocation rates by a factor of ten. Modern surgical practices include capsule repair techniques, like drilling holes through the trochanter or repairing soft tissues, to further minimize dislocation risks. Current findings suggest dislocation rates across various approaches are similar, emphasizing the importance of proper component positioning to restore hip biomechanics, including leg length and offset. Additionally, the segment touches on complications of the posterior approach, particularly sciatic nerve injuries, and highlights that skilled surgical technique can mitigate these risks.

DOI: 10.1302/3114-251146

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