A New Approach to Total Hip Replacement Without Osteotomy of the Greater Trochanter

Abstract

To be able to perform total hip replacement without osteotomy of the greater trochanter has specific advantages including reduced operating time, reduced blood loss and shorter rehabilitation time. However, the exposure is less wide than when the greater trochanter is osteotomized and likelihood of technical error is increased. A new approach is presented, involving complete capsulectomy without osteotomy of the greater trochanter, which provides wide exposure of the acetabulum and of the femoral neck. It permits total hip replacement to be done without osteotomy of the greater trochanter with satisfactory exposure in many instances. Specific contraindications against the use of this approach are those circumstances which require shortening of the limb, cases with severe distortion of the anatomy, cases of severe protrusio acetabulum and cases with marked scarring from previous surgery.