Affiliations: [a] Department of Spine Surgery and Scoliosis Center, Schön Klinik Neustadt in Holstein, Neustadt, Germany | [b] Musculoskeletal University Center, Ludwig Maximilian University of Munich, Munich, Germany | [c] Department of Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany | [d] Clinic of Veterinary Surgery, Ludwig Maximilian University of Munich, Munich, Germany | [e] MZEB der Stiftung ICP München, Munich, Germany | [f] Department of Orthopedic Surgery, Agaplesion Ev. Bathildiskrankenhaus Bad Pyrmont, Bad Pyrmont, Germany | [g] Katholisches Krankenhaus Hagen, Hagen, Germany
Correspondence:
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Corresponding author: Carolin Melcher, Department of Spine Surgery and Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23570 Neustadt in Holstein, Germany. E-mail: cmelcher@schoen-klinik.de.
Note: [1] These authors contributed equally to the work and share first authorship.
Abstract: BACKGROUND: Over the last 50 years arthroplasty became the gold-standard treatment for disabling conditions of the coxofemoral joint. Variations of anterior, lateral, and dorsal incision have been applied, but as each approach requires the incision and reflection of various muscles to gain adequate exposure of the joint results are still controversial. OBJECTIVE: The purpose of this study was to develop a minimal-invasive, tissue-sparing approach in sheep with reduced risks in animal testing. METHODS: 12 mature sheep underwent hip surgery as part of a study to evaluate a hip resurfacing system. In line with the preliminary cadaveric tests a modified, minimal-invasive, musclepreserving surgical approach was sought after. RESULTS: We developed a surgical approach to the coxofemoral joint in sheep using only blunt tissue dissection after skin incision without any limitations in joint exposure or increased blood loss/duration of surgery. CONCLUSION: Even though limitations occur and femoral orientation in sheep differs from man, joint forces have similar relative directions to the bone with similar bony and vascular anatomy. Therefore, this minimal-invasive muscle preserving approach might be a safe and comparable alternative in still inevitable animal testing.
Keywords: Hip replacement, blunt dissection, muscle-sparing approach, sheep
