Posterior Approach by Dr. Bose
| The post approach which I employ is traditionally known as the muscle sparing approach and the anterior and anterolateral approaches which is very popular in the U.S and some parts of Europe are the muscle compromising approaches. The muscle here refers to the Abductor group or the muscles which lift your leg sideways and is the most important muscle of the hip. The post approach spares this completely.However some muscle have to be cut in any approach to get access to the hip and in the post approach, one cuts the short ext rotators which are flimsy , small muscles in the back of the hip. These are stitched back. These muscles are relatively unimportant as the main ext rotator is the gluteus maximus which again is undisturbed. Increasingly surgeons the world over are realizing the importance of preserving capsule over the neck of the femur in resurfacing surgery especially in cases where there is little or no arthritis as in AVN and the blood supply comes from outside bone( extra-osseus) , in contrast to full blown arthritis where the blood supply to a large extent changes to inside bone( intra-0sseus) . This NCP approach ( Neck Capsule Preserving ) for resurfacing surgery was developed here in Chennai. The other benefit of the NCP approach is the fact the capsule is also repaired back completely so that the surgeon can confidentently advise patients that there wont be any restrictions post-op. The repaired capsule will prevent the patient from doing any awkward movement even inadvertently. Vijay Bose. consultant orthopaedic surgeon ChennaiSummary of Advantages – Posterior vs. Anterior Approach: The posterior approach for hip resurfacing has the following 1. No important muscle groups are sectioned. 2. There is no release of the abductor muscles. They are the 3. The gluteus medius and minimus remain intact. The only 4. The new instrumentation facilitates a smaller incision 5. The anterior approach requires removal of some of the |