METHODS FOR HIP REPLACEMENT WITH ANTERIOR VERTICAL CAPSULE INCISION ? MODIFIED ANATOMICAL DIRECT LATERAL APPROACH (VITOSHA APPROACat

摘要

The Modified anatomical direct lateral approach (Vitosha approach), a novel approach in hip arthroplasty, preserving the iliofemoral ligament and restoring the joint capsule, providing higher initial joint stability and easier rehabilitation without the need for post-operative patients' dislocation precautions is provided. The fascial incision curves along the posterior aspect of the greater trochanter and ends at its lower border, preventing a split of vastus lateralis muscle. The anterolateral periosteal layer which conjoins the gluteus medius and vastus lateralis muscles is sharply elevated from the greater trochanter. Gluteus medius muscle and the underlying gluteus minimus are split along its fibers and retracted anteriorly. A vertical capsular incision is made anterior to the femoral shaft, starting from the basicervical line and extending proximally along the longitudinal body axis, with the iliofemoral ligament fibers remained intact.