Joseph T. Moskal, MD
The modified direct lateral approach is a versatile surgical approach for primary and revision total hip arthroplasty (THA), allowing excellent exposure for complex reconstructive problems. Excellent exposure is provided for component orientation as well as for certain acetabular bone grafting procedures. Leaving the greater trochanter intact improves rotational stability that is needed in press fit femoral implants, allows better pressurization of methylmethacrylate when cementing femoral implants and is useful when trying to contain bone graft for certain proximal femoral deficiencies. The modified direct lateral approach is inadequate for patients who will require structural bone grafting for a pelvic dissociation or for an ilioischial defect of the posterior column, revision surgery with a proximal femoral allograft, or a femoral osteotomy required for a leg length discrepancy greater than 4 cm.
During his study, 453 consecutive primary revision THAs in 410 patients were performed by Joseph T. Moskal, M.D. The modified direct lateral approach was utilized in 306 of the 319 (96%) primary THAs and 115 of 134 (86%) of revision cases for a total of 421 of 453 (93%). In this segment, Dr. Moskal reviews his surgical technique, along with anatomic relationships, providing important information for the orthopaedic surgeon considering the utilization of the modified direct lateral approach for revision THA as well as primary THA.
- References Hardinge K The direct lateral approach to the hip JBJS 1982;464B:17
- Moskal J, Mann J A modified direct lateral approach for primary and revision total hip arthroplasty J Arthroplasty 1996;7(3)
- Total Run Time: 16:17 minutes
- Catalog Number: 4051
- VJO Publication Date: March, 1998