What is the name of the posterior approach for hip surgery?

The Posterior Approach for Hip Surgery

The posterior approach for hip surgery is simply called the "posterior approach." 1

Description and Characteristics

• The posterior approach is one of the three most common surgical approaches used for hip arthroplasty, alongside the direct lateral approach and direct anterior approach 2, 3
• It involves accessing the hip joint from the posterior aspect, with the patient typically positioned in the lateral decubitus position 4
• During the procedure, an incision is made at an oblique angle starting from the posterior-proximal corner of the greater trochanter 4

Variations of the Posterior Approach

• Traditional posterior approach (also known as Moore or Southern approach) involves violation of the iliotibial band and short external rotators 5, 4
• Modified posterior approach with complete posterior capsular and muscular repair has been developed to preserve the posterior hip capsule and short external rotators 6
• Direct Superior approach is a newer variation of the posterior approach that spares the iliotibial band, obturator externus tendon, and quadratus femoris muscle 4

Clinical Outcomes and Considerations

• According to the American Academy of Orthopaedic Surgeons (AAOS), the surgical approach (anterior, lateral, or posterior) does not significantly affect outcomes in hip fracture arthroplasty 1, 2
• The posterior approach has historically been associated with a slightly higher dislocation rate compared to anterolateral approaches, though this risk is reduced with proper soft tissue repair 5
• Studies have shown that patients who undergo THA via the posterior approach demonstrate better hip abductor and flexor muscle strength at 12 months post-surgery compared to those who undergo the lateral approach 7

Practical Applications

• The posterior approach is commonly used for total hip arthroplasty (THA) in cases of hip fracture and osteoarthritis 1
• When performing THA for displaced femoral neck fractures, the AAOS notes that the surgical approach choice should be based on surgeon experience rather than approach type 1, 2
• The posterior approach offers good visualization of both the acetabulum and femur, making it versatile for various hip procedures 3

Important Considerations

• Proper repair of the posterior capsule and external rotators is crucial when using the posterior approach to minimize dislocation risk 6
• Surgeon experience and comfort with a particular approach is often more important than the specific approach chosen 8, 2
• The choice between anterior, lateral, or posterior approaches should be based on patient factors, surgeon experience, and specific clinical scenarios rather than assuming superiority of any single approach 8, 2