title: The Wuerzburg procedure: the tensor fasciae latae perforator is a reliable anatomical landmark to clearly identify the Hueter interval when using the minimally-invasive direct anterior approach to the hip joint.
abstract: BACKGROUND
  The key for successful delivery in minimally-invasive hip replacement lies in the exact knowledge about the surgical anatomy. The minimally-invasive direct anterior approach to the hip joint makes it necessary to clearly identify the tensor fasciae latae muscle in order to enter the Hueter interval without damaging the lateral femoral cutaneous nerve. However, due to the inherently restricted overview in minimally-invasive surgery, this can be difficult even for experienced surgeons.
  In this technical note, we demonstrate for the first time how to use the tensor fasciae latae perforator as anatomical landmark to reliably identify the tensor fasciae latae muscle in orthopaedic surgery. Such perforators are used for flaps in plastic surgery as they are constant and can be found at the lateral third of the tensor fasciae latae muscle in a direct line from the anterior superior iliac spine.
  
  
  CONCLUSIONS
  As demonstrated in this article, a simple knowledge transfer between surgical disciplines can minimize the complication rate associated with minimally-invasive hip replacement.
authors: Department of Orthopaedic Surgery, University of Wuerzburg Koenig-Ludwig Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany. m-rudert.klh@uni-wuerzburg.de.
authors: Maximilian
authors: M
authors: Rudert
authors: Department of Orthopaedic Surgery, University of Wuerzburg Koenig-Ludwig Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany. k-horas.klh@uni-wuerzburg.de.
authors: Konstantin
authors: K
authors: Horas
authors: Department of Orthopaedic Surgery, University of Wuerzburg Koenig-Ludwig Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany. m-hoberg.klh@uni-wuerzburg.de.
authors: Maik
authors: M
authors: Hoberg
authors: Department of Orthopaedic Surgery, University of Wuerzburg Koenig-Ludwig Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany. a-steinert.klh@uni-wuerzburg.de.
authors: Andre
authors: A
authors: Steinert
authors: Dapartment of Trauma, Orthopaedics, Hand and Reconstructive Surgery, Clinic Harlaching, Sanatoriumsplatz 2, 81545, Munich, Germany. dominikholzapfel@icloud.com.
authors: Dominik Emanuel
authors: DE
authors: Holzapfel
authors: Institute of Anatomy and Cell Biology, University of Wuerzburg, Koellikerstr. 6, 97070, Wuerzburg, Germany. stefan-huebner@uni-wuerzburg.de.
authors: Stefan
authors: S
authors: Hübner
authors: Department of Orthopaedic Surgery, University of Wuerzburg Koenig-Ludwig Haus, Brettreichstr. 11, 97074, Wuerzburg, Germany. holzapfel@orthopaedic-oncology.net.|Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4049, Brisbane, Australia. holzapfel@orthopaedic-oncology.net.
authors: Boris Michael
authors: BM
authors: Holzapfel
mesh_terms: D059925:Anatomic Landmarks; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D002102:Cadaver; D004210:Dissection; D005260:Female; D005267:Femoral Nerve / Q000033:anatomy & histology*; D006621:Hip Joint / Q000033:anatomy & histology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology* / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome