Surgical procedures
The direct lateral approach (DLA): Following a posterior
curved lateral incision, the hip was exposed through a direct
lateral approach, as described by Frndak and modified by
Hardinge (1982). The deep fascia was split proximally in the
direction of the anterior fibers of the gluteus maximus, and
the common muscle plate of the anterior third of the vastus
lateralis and the gluteus medius was dissected subperiosteally
from the greater trochanter. During reconstruction of the
abductor muscles, the common muscle plate was reinserted
into the greater trochanter using 2 non-resorbable osteosutures.
This fixation was reinforced with a continuously sewn,
slowly resorbable, looped monofilament suture.