Courtesy: Vinay Kumar Singh, NIMS and EVAA Hospitals, Jaipur, India. Modified Hardinge Anterolateral Approach to the Hip Joint. Anterior Lateral Hip Precautions. In the lateral approach (also known as a Hardinge approach), the hip abductors (gluteus medius and gluteus minimus) are elevated – not cut – to provide access to the joint. (1979), the direct lateral ap- proach by Hardinge (1982). Anterior Hip Replacement Lateral Approach (also called Hardinge appraoch) This approach is from the side of the hip. Anterior and Posterior Lateral Hip Precautions Following total hip replacement surgery, certain positions cause undue stress on your hip and could cause the prosthesis to dislocate. Title: x19191_Anterior_Hip_Precautions.indd Choosing the optimal surgical approach can minimize these risks and therefore improve the outcome of THA. Posterior approach a. Do not cross or turn surgical leg/ toes outward. Posterior Approach Gluteus medius is ... Total Hip Arthroplasty Precautions 4)Rotate your operated leg outward. Surgical approaches in THA include anterior, lateral [anterolateral (Hardinge) and direct lateral (Watson-Jones)], posterior (posterolateral and posterior) and posterior-2 … Do not move surgical leg out to the side. Totals can be anterior approach (no hip precautions and WBAT) – Anterior lateral approach (Hardinge), hip precautions 6 weeks – Posterior approach (Kocher-Langenbach), hip precautions 6 weeks • If right leg, driving almost immediate with Anterior approach, 4 weeks typically for other 2 These tendons may not heal properly after they are reattached leading to chronic pain, trochanteric bursitis and limping. No combination of above motions allowed for 6 weeks post-op Direct anterior approach: Active hip extension and external rotation is allowed. Related Posts. Southern Approach [3] 4. In the modified Hardinge approach, access to the hip joint was achieved through an abductor mus-cle split; the gluteus medius was split longitudinally at the junction of the anterior third to posterior two-thirds of the muscle width and the split was not Hardinge Approach for Bipolar Hip Hemiarthroplasty. It requires detaching the gluteal tendons and muscles from the top of the femur. Use leg lifteror helper to bring leg out to the side. Post Views: 5,148. • Hip ROM 0-90 degrees Weeks 6 - 9 • Cane as needed, D/C when gait is normal • Continue to caution against hip flexion > 90 degrees • Continue to sleep on back • D/C pillow between legs while sleeping • Continue appropriate previous exercises • Progressive abductor strengthening – In standing – Sidelying Precautions Posterior approach: No hip flexion > 90 º no hip internal rotation or adduction beyond neutral. e AdvocateAuroraHealth For Your Well -Being make healthy happen . Encourage normal extension/stride with gait Modified lateral ( Hardinge approach) Rehabilitation Implications Advantages - Risk of dislocation is low, 0.5% ( posterior capsule is left intact ) Disadvantages - Abductors are incised. Do not move surgical leg backward. 2)Pivot on you operated leg when turning(in standing), take small steps instead. REHABILITATION GUIDELINES FOR TOTAL HIP REPLACEMENT(DIRECT LATERAL APPROACH DO NOT: 1)Cross your legs when lying or sitting. This approach has been modified in the transgluteal approach by Bauer et al. Direct Lateral /Hardinge b. Antero-Lateral /Watson Jones 3. Medial approaches ... Precautions should also be taken not to damage the superior gluteal nerve. Limit passive extension and external rotation. approach to the hip on their anatomical observation that the gluteus medius and vastus lateralis are in di- rect functional continuity through the thick tendinous periosteum covering the greater trochanter. Your surgeon will determine which precautions you should follow to make your recovery safe and comfortable. 3)Sleep on your operated side for 6-8 weeks to avoid irritation to your hip. The hip joint is then dislocated and the acetabular socket and femur are exposed for preparation and insertion of the prosthesis components.
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