MAASH Technique for Total Hip Arthroplasty: A Capsular WorkReport as inadecuate

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HSS Journal ®

, Volume 9, Issue 2, pp 171–179

First Online: 21 June 2013Received: 30 December 2012Accepted: 27 March 2013


BackgroundDislocation and leg length discrepancy are major complications following total hip arthroplasty THA. Many surgical approaches for THA have been described, but none suggest a capsular incision that assures good exposure while maintaining adequate capsule integrity in closure.

PurposesModified anterolateral approach for stable hip MAASH is a modification of the classical Hardinge approach, but specifically preserves the anterior iliofemoral lateral ligament and pubofemoral ligament excising the -weak area- of the capsule, in the so called -internervous safe zone- and introducing the -box concept- for the anterior approach to the hip. This is the main difference of the MAASH approach. This technique can be used as a standard for all THA standard models, but we introduce new devices to make it easier.

MethodsFrom November 2007 to May 2012, data were collected for this observational retrospective consecutive case study. We report the results of 100 THA cases corresponding to the development curve of this new concept in THA technique.

ResultsMAASH technique offers to hip surgeons, a reliable and reproducible THA anterolateral technique assuring accurate reconstruction of leg length and a low rate of dislocation. Only one dislocation and six major complications are reported, but most of them occurred at the early stages of technique development.

ConclusionMAASH technique proposes a novel concept on working with the anterior capsule of the hip for the anterolateral approach in total hip arthroplasty, as well as for hemiarthroplasty in the elderly population with high dislocation risk factors. MAASH offers maximal stability and the ability to restore leg length accurately.

Keywordship arthroplasty hip approach anterior hip capsule THA stability leg length discrepancy hip capsule anatomy Level of Evidence: Therapeutic Study Level IV

Work performed at Hospital de Sant Celoni, Sant Celoni, Barcelona, Catalonia, Faculty of medicine. University of Girona, Catalonia, Spain.

Electronic supplementary materialThe online version of this article doi:10.1007-s11420-013-9332-1 contains supplementary material, which is available to authorized users.

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Author: Felipe G. Delgado - Albert Broch - Francisco Reina - Lluís Ximeno - David Torras - Francesc García - Antoni Salvador


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