Total Hip Arthroplasty, Case 4: Posterior Approach

Study Total Hip Arthroplasty, Case 4: Posterior Approach through an immersive first-person surgical case from the Bone Reconstruction channel on Surgie. The module focuses on anatomical posterior approach with piriformis preservation, osteotomy and acetabular exposure, and acetabular preparation with press-fit cup and posterosuperior screw fixation.

Procedure Overview

The case is organized for structured review of surgical anatomy, procedural sequencing, instrument handling, reduction or reconstruction strategy, implant positioning, and intraoperative verification. Expert narration connects the visual field with the decisions documented during the procedure.

What You Will Observe

• Anatomical posterior approach with piriformis preservation
• Osteotomy and acetabular exposure
• Acetabular preparation with press-fit cup and posterosuperior screw fixation
• Liner positioning with 10° lip orientation
• Femoral preparation with uncemented stem and acoustically guided broaching
• Dynamic stability tests and soft tissue assessment

Key Technical Decisions

• Piriformis preservation and robust transosseous repair of capsule/rotators to reduce dislocation risk and reinforce the posterior envelope
• press-fit acetabular fixation with circumferential reaming, ceiling-directed screws, and posterosuperior 10° lip liner for enhanced stability
• Reproducible femoral sequence using "cortical grip" acoustic criteria to standardize broach progression and stem implantation
• Dynamic validation protocol with >90° flexion and internal rotation tests, tissue tension adjustment, and length verification before final reduction
• Efficient exposure system (Hohmann + posts) that accelerates access and minimizes soft tissue trauma, with iliotibial tract closure in abduction

Included With This Training

• Technical PDF summarizing the procedure, operative sequence, and key review points.

Learning Format

First-person operative footage, surgeon-led narration, and case-based visual review designed to support preparation before supervised clinical training.

Educational notice: This content supports professional education and does not replace formal training, institutional protocols, patient-specific planning, or supervised clinical judgment.