Minimally invasive medial hip approach

• Published in: Orthopaedics & traumatology, surgery & research Vol. 100; no. 6; pp. 687 - 689
• Main Authors: Chiron, P, Murgier, J, Cavaignac, E, Pailhé, R, Reina, N
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.10.2014
• Subjects: Adductors; Adolescent; Adult; Aged; Female; Foreign body; Fracture; Hip approach; Hip Joint - surgery; Humans; Iliopsoas; Male; Middle Aged; Minimally invasive surgery; Minimally Invasive Surgical Procedures - methods; Orthopedics; Patient Positioning; Surgery; Tumor; Young Adult; Hip approach; Minimally invasive surgery; Tumor; Fracture; Foreign body; Adductors; Iliopsoas
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2014.06.009

Abstract The medial approach to the hip via the adductors, as described by Ludloff or Ferguson, provides restricted visualization and incurs a risk of neurovascular lesion. We describe a minimally invasive medial hip approach providing broader exposure of extra- and intra-articular elements in a space free of neurovascular structures. With the lower limb in a “frog-leg” position, the skin incision follows the adductor longus for 6 cm and then the aponeurosis is incised. A slide plane between all the adductors and the aponeurosis is easily released by blunt dissection, with no interposed neurovascular elements. This gives access to the lesser trochanter, psoas tendon and inferior sides of the femoral neck and head, anterior wall of the acetabulum and labrum. We report a series of 56 cases, with no major complications: this approach allows treatment of iliopsoas muscle lesions and resection or filling of benign tumors of the cervical region and enables intra-articular surgery (arthrolysis, resection of osteophytes or foreign bodies, labral suture).