J Orthop Case Rep. 2018 Mar-Apr; 8(2): 26–29.

Osteotendinous Suturing for Anchorage of Hip Abductor Mechanism in Total Hip Arthroplasty through a Lateral Approach: A Technical Note

Sanjay Agarwala1 and Naeem Jagani2
Hip

Introduction:

We describe a novel technique for approximation and reattachment of the capsule, hip abductors, and vastuslateralis muscles during closure of the arthrotomy and surgical wound, after total hip arthroplasty through a modified direct lateral approach. This anatomical restoration of soft tissues could thereby lead to early post-operative rehabilitation and recovery.

Case Report:

This is a method of osteotendinous suturing that could lead to reestablishing the functional continuity of the gluteus minimus, medius muscles, and the anterior capsule through drill holes in the greater trochanter, and thereby preserve the integrity of the hip abductor musculature. This is a simple and easily reproducible technique of soft tissue approximation and reattachment that results in early mobilization and ambulation of the patient with no additional complications and have several advantages over the other methods used for closure.

Conclusion:

This osteotendinous technique can be used for arthrotomy closure after both primary and revision total hip arthroplasties through the lateral approach (Hardinge and modified Hardinge) to the hip.

Keywords: Capsular repair, gluteus medius reattachment, hip abductor integrity, total hip replacement, transosseous suturing

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