Acetabular orientation: anterolateral approach in the supine position.
The anterolateral approach in the supine position provides excellent visualization of the acetabulum. The main advantage of the approach, a low dislocation rate, has been demonstrated in the literature, while the purported disadvantage of abductor dysfunction has not been clearly delineated in the literature. The technique requires meticulous attention to preservation of the gluteus medius and minimus tendons. Impingement and dislocation are avoided by careful attention to the preparation of acetabulum, critical assessment of the implanted components, and intraoperative trialing. Leg lengths are assessed through direct palpation of the malleoli. Routine use of postoperative hip precautions is not necessary when this approach is utilized. The anterolateral approach in the supine position allows for a reproducible result with a low dislocation rate.


METHODS
Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Austin
Matthew S
MS
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, Philadelphia, PA 19107, USA. matt.austin@rothmaninstitute.com
Rothman
Richard H
RH
D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D016683:Supine Position