title: [Surgical access routes to the hip joint in the elderly].
abstract: There are a large number of different approaches to the hip joint. Several conventional and minimally invasive portals exist and numerous technical variations with different instrument sets are available. All approaches can be regarded as standard and can be utilized lege artis. The main differences between approaches are their potential to preserve muscles and avoid damage which would slow down rehabilitation and mobilization. In the elderly the preservation of abductor function is, in the authors' opinion, of utmost importance. A well-functioning gluteal system provides a limp-free gait, supports joint stability and reduces the probability of dislocations. The direct anterior approach has some advantages; however, minimally invasive approaches should be used with care. Surgical experience, experience with a specific approach and the availability of specialized instruments as well as sufficient training are mandatory for a successful performance. A surgeon should always choose the approach with which he has most experience.
authors.affiliation: Experimentelle Orthopädie, Medizinische Universität Innsbruck, Innrain 36, 6020, Innsbruck, Österreich. Michael.nogler@i-med.ac.at.
authors.forename: M
authors.initials: M
authors.lastname: Nogler
authors.affiliation: Universitätsklinik für Orthopädie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
authors.forename: M
authors.initials: M
authors.lastname: Thaler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005858:Germany; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D009985:Orthopedics / Q000639:trends*; D011474:Prosthesis Design; D016896:Treatment Outcome
keywords: Dislocation; Gluteal insufficiency; Joint stability; Minimally invasive; Surgery