Total Hip Precautions

Question 1

Direct Lateral Approach

Answer 1

Longitudinal division of TFL & vastus lateralis, + release of anterior glut med. minimizes probability of dislocation, ideal for non-compliant patients

Precautions: NO flex past 90, hip ext, lat rot, ADD beyond neutral

Question 2

Posterolateral Approach

Answer 2

Access through split glut max, released short ext rotators/ hip ABD retracted anteriorly. Maintains integrity of glut med/vastus lateralis. Femur dislocated posteriorly. Most common w/ high post-op dislocation rate

Precautions: NO hip flex beyond 90, ADD, med rotation

Question 3

Anterolateral approach

Answer 3

Access through interval between TFL and glut med. some of ABD released from greater trochanter, hip dislocated anteriorly

Precautions: NO flex beyond 90, hip ext, lat rotation, ADD past neutral