Electronic Letters to:

Hip: C. P. Little, A. L. Ruiz, I. J. Harding, P. McLardy-Smith, R. Gundle, D. W. Murray, and N. A. Athanasou Osteonecrosis in retrieved femoral heads after failed resurfacing arthroplasty of the hip J Bone Joint Surg Br 2005; 87-B: 320-323 [Abstract] [Full text] [PDF]

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Surgical approach for hip resurfacing

Harish V Kurup   (27 October 2005)

Surgical approach for hip resurfacing 27 October 2005
Harish V Kurup, Specialist Registrar in Orthopaedics Ysbyty Gwynedd, Bangor, North Wales LL57 2PW. Send letter to journal: Re: Surgical approach for hip resurfacing harishvk{at}yahoo.com Harish V Kurup	Sir, I read this article with great interest. The authors have found a significant incidence of secondary avascular necrosis in this series (12 out of 377, 3.2%). I have noticed from the article that the authors have been using a posterior approach for hip resurfacing. In recent literature most authors seem to be using a similar posterior approach with anterior1 or posterior capsulotomy.2 Hip resurfacing needs an adequate exposure while respecting the local biology. The Ganz approach3 seems to provide this adequately. This exposure protects in the medial circumflex femoral artery, which supplies the femoral head. My consultant, Mr Glynne Andrew uses this approach for hip resurfacing and I was indeed surprised to find that most authors are using a standard posterior approach. Thank you Yours truly Harish Kurup, Specialist Registrar Ysbyty Gwynedd, Bangor, North Wales LL57 2PW. References: 1. Back DL, Dalziel R, Young D, Shimmin A. Early results of primary Birmingham hip resurfacings: an independent prospective study of the first 230 hips. J Bone Joint Surg [Br] 2005;87-B:324-9. 2. Treacy RB, McBryde CW, Pynsent PB. Birmingham hip resurfacing arthroplasty: a minimum follow-up of five years. J Bone Joint Surg [Br] 2005;87-B:167-70. 3. Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg [Br] 2001;83-B:1119-24.