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Moore or Southern posterior approach to the hip; S. Smith-Petersen anterior approach to the hip; W. Watson-Jones anterolateral approach to the hip
The anterior approach accesses the hip joint from the front, with less large muscle dissection but due to the proximity of the femoral artery, corresponding vein, and main nerve bundle for the leg lying just medial to the acetabulum the surgeon must exercise caution and maintain suitable landmarks.
The modified posterior MIS approach to hip resurfacing and total hip arthroplasty (hip replacement) displays a host of advantages to the patient: Less post-operative pain; Less soft tissue damage and pressure on muscle fibres. Shorter hospital stay; Lower blood loss; Smaller incision; Quicker return to work and functional activities [2]
The anterior approach uses an interval between the sartorius muscle and tensor fasciae latae. This approach, which was commonly used for pelvic fracture repair surgery, has been adapted for use in hip replacement. When used with older hip implant systems that had a small diameter head, dislocation rates were reduced compared to posterior surgery.
The anterior longitudinal approach: the probe is aligned along the long axis of the femoral neck. The needle is introduced from an anteroinferior approach and is passed into the anterior joint recess at the femoral head-neck junction. Anterolateral approach, here shown as a transverse image. The needle will rest on the femoral head (arrow).
The posterior approach is the most common and practical of those used to expose the hip joint. The posterior approaches allow excellent visualization of the femoral shaft, thus are popular for revision joint replacement surgery in cases in which the femoral component needs to be replaced.
Posterior dislocations is when the femoral head lies posteriorly after dislocation. [5] It is the most common pattern of dislocation accounting for 90% of hip dislocations, [5] and those with an associated fracture are categorized by the Thompson and Epstein classification system, the Stewart and Milford classification system, and the Pipkin system (when associated with femoral head fractures).
The pelvic bone, also known as the innominate bone, is formed by three bones fused together: the ilium, ischium, and pubis. The musculature of the hip is divided into anterior hip muscles and posterior hip muscles. The major nerve supply that runs through the hip joint is the femoral nerve and the sciatic nerve. [16]