Surgical principle and objective
Autor: Dr. H. Quitmann. Implantation of a total hip arthroplasty with a muscle sparing minimally invasive approach without dislocation of the femoral head with preservation of the capsule.
Lateral decubitus position, skin incision of 6–10 cm from the tip of the greater trochanter in line with the femoral axis, incision of the fascia of the gluteus maximus muscle, blunt dissection of the fibers, incision of the bursa at the posterior boarder of the gluteus maximus muscle, using the space between the piriformis posterior and the gluteus minimus and medius muscle anterior, incision of the capsule, opening of the femoral canal with a starter reamer, creating a channel in the corticalis of the lateral neck up to the lateral part of the head with a round calcar punch, sequentially broaching of the femur, osteotomy the femoral neck at the tip of the femoral broach left in situ, removal of the femoral head, preparation of the acetabulum, use of a cannula posterior of the femur to pass the reamer drive shaft, connecting the acetabular basket reamer through the main incision, cup impaction and implantation of the inlay, trial modular neck and head, reposition, intra-operative radiograph, test of leg length, impingement and stability, implantation of the definitive components, closure of the capsule, standard wound closure.
