title: The SPAIRE technique allows sparing of the piriformis and obturator internus in a modified posterior approach to the hip.
abstract: BACKGROUND
  The Sparing Piriformis and Internus, Repair Externus (SPAIRE) technique allows a muscle sparing mini-posterior approach to the hip.
  
  
  METHODS
  We present in this article a description of an adaptation of the familiar posterior approach (PA) in which the only tendon released is obturator externus. Termed SPAIRE, this muscle sparing technique enables preservation of the piriformis tendon and conjoint insertion of obturator internus and the gemelli. The technical description allows for safe and reliable replication by any surgeon familiar with the posterior approach (PA) to the hip without reliance on additional equipment, and without compromising the ability to convert into a more extensile approach.
  
  
  CONCLUSIONS
  This technical description and brief discussion of rationale outlines the ongoing work of the authors in developing the SPAIRE technique as part of the spectrum of the posterior approach to the hip. The senior author now uses this technique routinely for total hip replacements and hemiarthroplasty. Patients are mobilised with no postoperative restrictions whatsoever. Other potential advantages include improved gait, more anatomical restoration of hip function, and enhanced stability. Projects have been initiated in our unit to objectively assess the possible clinical advantages relating to use of the SPAIRE technique using gait analysis, objective measurement of muscle power and studies of hip stability.
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter - UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hanly
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter - UK.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Sokolowski
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter - UK.|College of Engineering, Maths and Physical Science, University of Exeter, Exeter - UK.
authors.forename: Andrew John
authors.initials: AJ
authors.lastname: Timperley
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000534:rehabilitation*; D004434:Early Ambulation; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D059351:Organ Sparing Treatments / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D056888:Patient Positioning; D016658:Psoas Muscles; D020127:Recovery of Function; D013997:Time Factors