Our Experience with Modified Lateral Approach for Total Hip Replacement – A Midterm Study

Volume 6 | Issue 2 | May-Aug 2018 | Page:16-20 | Madhuchandra P, Raju K P, Arun K M

Authors: Madhuchandra P [1], Raju K P [1], Arun K.N [1], Pawan Kumar K M [1].

[1] Department of Orthopaedics, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. P Madhuchandra,

Department of Orthopaedics,

BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India.



Background: Numerous approaches have been described in the literature for total hip replacement surgeries. Each of the approach has got its own merits and demerits. Modified lateral approach gives the best visualization and orientation of both acetabular cup and femur; furthermore, rates of dislocation are very less. However, damage to abductor mechanism is a major disadvantage. We have evaluated the clinical and functional outcomes of modified lateral approach in this midterm study.

Materials and Methods: The study was conducted in a tertiary institute in a prospective and retrospective manner. The study period was from January 2007 to December 2012 for 6 years. The study sample was 119 patients who underwent total hip replacements for different indications. 7 patients were lost to follow up for reasons unknown, so a total of 112 patients were included in the study who were in regular follow-up. All the patients were evaluated for clinical and functional outcomes using modified Harris hip score, and abductor mechanism was evaluated by electrophysiological studies and Trendelenburg test.

Results: Functional outcome was evaluated using modified Harris hip score. We had excellent results in 44 (39.2%) hips, good in 62 (55.5%) hips, and fair in 6 (5.5%) hips. There were no cases with poor outcomes. 92 patients (82.2%) had negative modified Trendelenburg test, whereas 20 patients (17.8%) had positive modified Trendelenburg test. Electrophysiological studies were done in 58 patients, which showed that there were no injuries to superior gluteal nerve in any of our cases.

Conclusion: Modified direct lateral approach is a wonderful approach for the total hip replacement surgeries. It gives better visualization and orientation of the components with lesser incidence of dislocations and good abductor strength is retained provided careful dissection is done taking care not to injure superior gluteal nerve.

Keywords: Lateral approach, total hip replacement, Harris hip score, Trendelenburg test.


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How to Cite this article: Madhuchandra P, Raju K P, Arun K.N, Pawankumar K M. Our Experience with Modified Lateral Approach for Total Hip Replacement – A Midterm Study. J Kar Orth Assoc. MayAug 2018; 6(2):16-20.

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A prospective study of surgical mamnagment of intertrochanteric fractures of femur treated with trochanteric femoral nail

Volume 6 | Issue 1 | Jan-April 2018 | Page 39-42 | Vinay Patil, Nishant Panegaon, Lalit kumar Joon

Authors: Vinay Patil [1], Nishant Panegaon [1], Lalit kumar Joon [1].

[1]Department of Orthopaedics, M R Medical college, Kalaburgi, 585105, Karnataka, India

Address of Correspondence
Dr. Lalit Kumar Joon,
Department of Orthopaedics, M R Medical college,
Kalaburgi, 585105, Karnataka, India


Background: Intertrochanteric fractures are the most frequent fractures of the proximal femur and occur predominantly in geriatric patients and are among the most devastating injuries in the elderly. Since the general life expectancy of the population has increased significantly during past few decades leads to increase in incidence of these fractures and subsequently development of newer designs of implants for fixation of these fractures. Trochanteric femoral nail is a newly introduced nail for internal fixation, compared to single lag screw , the TFN with two screws yielding superior life to cut out and uncontrolled collapse at fracture site. In this prospective study operative time, blood loss, functional outcome and complications are studied.
Materials and Methods: 50 patients diagnosed with Intertrochanteric femur fracture were treated in our hospital. Classification used is Boyd and griffin, Excluding type 4 .Surgery performed after getting the medical fitness. Patient on traction table in supine position through lateral approach. Clinical outcome assessed with Harris hip score at the end of 6 months .
Results: This prospective study shows that Harris Hip score at 6 months was 85% in type I, 61%in type II, and 68% in type III frac-tures.
Conclusions: TFN gave good results clinically and functionally with early return to pre fracture activities to the patients.
Keywords: TFN, Intertrochanteric fracture, Harris hip score.


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How to Cite this article: Patil V, Panegaon N, Joon L K. A prospective study of surgical mamnagment of intertrochanteric fractures of femur treated with trochanteric femoral nail. J Kar Orth Assoc. Jan-Apr 2018; 6(1): 39-42

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