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Delgado FG, Broch A, Reina F, et al. MAASH Technique for Total Hip Arthroplasty: A Capsular Work. HSS J. 2013;9(2):171-9doi: 10.1007/s11420-013-9332-1.
Delgado, F. G., Broch, A., Reina, F., Ximeno, L., Torras, D., García, F., & Salvador, A. (2013). MAASH Technique for Total Hip Arthroplasty: A Capsular Work. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 9(2), 171-9. https://doi.org/10.1007/s11420-013-9332-1
Delgado, Felipe G, et al. "MAASH Technique for Total Hip Arthroplasty: A Capsular Work." HSS journal : the musculoskeletal journal of Hospital for Special Surgery vol. 9,2 (2013): 171-9. doi: https://doi.org/10.1007/s11420-013-9332-1
Delgado FG, Broch A, Reina F, Ximeno L, Torras D, García F, Salvador A. MAASH Technique for Total Hip Arthroplasty: A Capsular Work. HSS J. 2013 Jul;9(2):171-9. doi: 10.1007/s11420-013-9332-1. Epub 2013 Jun 21. PMID: 24009535; PMCID: PMC3757492.
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HSS J. 2013 Jul;9(2):171-9. doi: 10.1007/s11420-013-9332-1. Epub 2013 Jun 21.

MAASH Technique for Total Hip Arthroplasty: A Capsular Work.

HSS journal : the musculoskeletal journal of Hospital for Special Surgery

Felipe G Delgado, Albert Broch, Francisco Reina, Lluís Ximeno, David Torras, Francesc García, Antoni Salvador

Affiliations

  1. Orthopedic and Trauma Department of the Hospital de Sant Celoni, Av. Hospital, 19, 08470 Sant Celoni, Barcelona, Catalonia Spain ; Arthrocat SLP, Group of Orthopedic Surgery and Sports Medicine, Sant Celoni, Spain.

PMID: 24009535 PMCID: PMC3757492 DOI: 10.1007/s11420-013-9332-1

Abstract

BACKGROUND: Dislocation 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.

PURPOSES: Modified 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.

METHODS: From 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.

RESULTS: MAASH 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.

CONCLUSION: MAASH 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.

Keywords: THA stability; anterior hip capsule; hip approach; hip arthroplasty; hip capsule anatomy; leg length discrepancy

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