The minimally invasive anterolateral approach combined with hip onlay resurfacing.
OBJECTIVE
Minimally invasive anterolateral approach in hip resurfacing with complete preservation of muscular integrity.


METHODS
Primary or secondary osteoarthritis of the hip.


METHODS



METHODS
None. Onlay implant: Females>55 years with osteoporosis. Males>60 years with osteoporosis. Severe varus deformity (CCD [collodiaphyseal] angle<100 degrees). History of metal allergy. Clinically relevant renal insufficiency. Radiologic appearance of avascular necrosis stage 3 and 4 according to Ficat. Femoral head cysts>1 cm in diameter.


METHODS
Supine position with possible overextension of the hip, longitudinal incision along the intermuscular septum and blunt intermuscular dissection between gluteus medius and tensor fasciae latae, partial resection of the anterior capsule and anterior dislocation of the hip with complete proximal release of the capsule. Dislocation of the femoral head and dorsal positioning, reaming of the acetabulum to implant the cementless acetabular component, exposition and reaming of the femoral head in extension/adduction and external rotation, implantation of the cemented onlay endoprosthesis.


METHODS
Prophylaxis of thromboembolism and periarticular ossification. Rehabilitation with weight bearing as tolerated starting on the day of surgery, ergometer training from day 4 after surgery.


RESULTS
31 patients with osteoarthritis underwent onlay resurfacing via a minimally invasive approach. The Harris Hip Score improved from 43.9 to 97.1 at 12 months after surgery. Adverse events such as fracture, dislocation, nerve or muscle lesions did not occur, and clinically significant thromboembolism or infection was not observed.
Gerdesmeyer
Ludger
L
Department of Orthopedics and Traumatology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany. Gerdesmeyer@aol.com
Gollwitzer
Hans
H
Diehl
Peter
P
Buttgereit
Björn
B
Rudert
Maximilian
M