K Mohan Iyer
Senior Orthopaedicians, India
He had this rare privilege and honor of doing this work at the University of Liverpool, UK along with Dr. Martin A Elloy, PhD, (A biomechanical study of fixation of femoral neck fractures. PhD Thesis, University of Liverpool, Liverpool 1977). a biomedical Engineer who was instrumental in helping me in the cadaveric study prior to clinical application in patients to device a Modified Posterior Approach to the Hip Joint at a time when dislocations were the main reason for the conventional Posterior Approach to the Hip Joint not being used despite of having all its advantages. He was formerly General Manager of Chas F Thackray Ltd and was at that time associated with Sir John Charnley at Wrightinton. I first presented this research at Singapore in 1984, when it was appreciated by Emeritis Professor, Robert Cofield of the Mayo Clinic, Minnesota, USA and I have been following this approach till today along with citations
The posterior approach is the most common and relatively easy to expose the hip joint. The posterior approaches allow excellent visualization of the acetabulum and the upper femoral shaft and hence, are very popular in revision joint replacement surgery particularly in cases where only the femoral component needs to be replaced. This modification offers greater visibility and decreased blood loss to the hip joint, conferring greater stability posteriorly as compared with the conventional posterior approach as described by Austin Moore in 1957. This modification was devised at the time when the cause of dislocation was being blamed on the posterior approach to the hip joint. This approach has been tested on cadavers prior to clinical application in patients, and since bone is attached to bone, it confers greater stability than an ordinary suture through soft tissues and hence reduces dislocation of the hip joint.