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dc.contributor.authorSolomon, L.en
dc.contributor.authorHofstaetter, J.en
dc.contributor.authorBolt, M.en
dc.contributor.authorHowie, D.en
dc.identifier.citationBone and Joint Journal, 2014; 96-B(1):48-53en
dc.description.abstractWe investigated the detailed anatomy of the gluteus maximus, gluteus medius and gluteus minimus and their neurovascular supply in 22 hips in 11 embalmed adult Caucasian human cadavers. This led to the development of a surgical technique for an extended posterior approach to the hip and pelvis that exposes the supra-acetabular ilium and preserves the glutei during revision hip surgery. Proximal to distal mobilisation of the gluteus medius from the posterior gluteal line permits exposure and mobilisation of the superior gluteal neurovascular bundle between the sciatic notch and the entrance to the gluteus medius, enabling a wider exposure of the supra-acetabular ilium. This technique was subsequently used in nine patients undergoing revision total hip replacement involving the reconstruction of nine Paprosky 3B acetabular defects, five of which had pelvic discontinuity. Intra-operative electromyography showed that the innervation of the gluteal muscles was not affected by surgery. Clinical follow-up demonstrated good hip abduction function in all patients. These results were compared with those of a matched cohort treated through a Kocher-Langenbeck approach. Our modified approach maximises the exposure of the ilium above the sciatic notch while protecting the gluteal muscles and their neurovascular bundle.en
dc.description.statementofresponsibilityL.B. Solomon, J.G. Hofstaetter, M.J. Bolt, D.W. Howieen
dc.publisherBritish Editorial Society of Bone and Joint Surgeryen
dc.rights© 2014 The British Editorial Society of Bone & Joint Surgeryen
dc.subjectHip; extended approach; Revision ; Total hip replacement; Superior gluteal bundle; Gluteus mediusen
dc.titleAn extended posterior approach to the hip and pelvis for complex acetabular reconstruction that preserves the gluteal muscles and their neurovascular supplyen
dc.typeJournal articleen
pubs.library.collectionOrthopaedics and Trauma publicationsen
dc.identifier.orcidSolomon, L. [0000-0001-6254-2372]en
dc.identifier.orcidHowie, D. [0000-0003-1702-3279]en
Appears in Collections:Orthopaedics and Trauma publications

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