Table 3

Tips and tricks for posterior approach.

Soft tissue management • We encourage a minimally-invasive approach with preservation of piriformis tendon.
• No specific recommendations for closing and reconstructing of the joint capsule and external rotator muscles.
• Keep the transverse acetabular ligament intact to determine the acetabulum version.
Acetabulum preparation • Requires a good acetabular exposure.
• Start by reaming vertically with a small diameter reamer in order to remove all the osteophytes around the acetabular fossae.
• The inferior edge of the reamer is then placed in line with the transverse acetabular ligament to respect anatomic anteversion.
• Try to use smallest cup size that will allow a good primary fixation.
Cup positioning • Keep a sufficient anteversion to avoid psoas impingement and decrease the risk of dislocation.
• A supero-posterior bone coverage defect of the cup is often observed and has no consequences.
Intraoperative testing • For stability tests, the hip is flexed at 90° and an internal rotation is gradually applied. If dislocation occurs at more than 45°, the THA is considered stable.
• For length and femoral offset parameters, the piston sign observed with knee fully extended has to disappear when the knee is flexed at 90° of flexion.

Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.

Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.

Initial download of the metrics may take a while.