The posterior approach to total hip replacement is the most common approach to total hip replacement, with nearly 70 percent of orthopaedic surgeons in the U.S. using this approach.
In the posterior approach to total hip replacement, the surgeon accesses the hip joint through an incision close to the buttocks. The approach goes behind the major walking muscles (abductors) and does not disrupt them.
Small tendons directly behind the hip joint are detached and the hip joint capsule is opened to access the hip joint. Both the capsule and the tendons are typically reattached later in the operation.
The posterior approach is applicable to all hip replacement scenarios. It can be done as a minimal incision technique or expanded to allow for treatment of more complex problems.
Potential advantages for the posterior approach include:
Because the posterior approach goes through posterior stabilizing structures, the early dislocation rate is higher than with anterior approaches, although this difference has become minimal over the years with improvements in surgical technique and implant design.
To minimize this risk, the patient is asked to follow “posterior precautions” for the early postoperative period. These include not crossing the leg, no bending of the hip past 90 degrees, and not pointing the toes inward.
The overall risk of dislocation after posterior approach hip replacement is between 1 and 2 percent.
Surgeons who perform this surgery are experts at using this approach and consistently achieve excellent long-term outcomes.
Call 888-ASK-DUKE (888-275-3853) to schedule an appointment with a Duke orthopaedist in Raleigh, Durham, or Cary, North Carolina.
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