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Surgical Technique: Modified Anterolateral Approach for Stable Hip (MAASH) is a novel surgical concept focused on the
anatomy and biomechanics of the hip capsule. It specifically preserves all of the posterior capsule, the anterior Iliofemoral
lateral ligament and the pubofemoral ligament by excising only the central third of the hip capsule (the non-innervated space
or weak area) along the femoral head-neck axis. MAASH provides a novel surgical technique to all THA approaches and
changes the focus from muscle balancing to capsular balancing (the box concept). This capsular approach philosophy can be
used as a standard for all THAs.
Background: Dislocation, leg length limb discrepancy and aseptic loosening are major complications following total hip
arthroplasty (THA). Many surgical approaches, complex surgical devices as well as computer navigation techniques have
been previously described for THA. However, none of them have offered an approach that results in a wide capsular surgical
working area that can assure good capsular exposure and the preservation of capsule integrity.
Methods: We collected data from November 2007 to April 2015 from n= 250 patients that underwent THA using the MAASH
technique. Surgical outcomes, statistical analysis, complications and conclusions of this new concept in THA approach were
analyzed and reported.
Results: MAASH technique offers to hip surgeons a reliable and reproducible THA approach that assures excellent leg length
discrepancy results and high stability in all range of motion without impingement. Only one dislocation (0.4%) and 5 major
complications (2%) were reported in the MAASH cohort, most of which occurred at the early stages of technique development.
Conclusions: The MAASH technique is an anterior capsular concept for the anterolateral approach in total hip arthroplasty,
which may be advantageous for active THA candidates and for patients with a high risk of dislocation as it does not rely solely
on muscle balancing. The capsular balancing concept is the key factor that MAASH offers. It provides maximum stability,
excellent leg length discrepancy and minimizes wear (no micro motion), which allows patients to recover fastersafer and can
potentially diminish the economic burden on patients and the overall healthcare system.
Biography
Felipe G. Delgado Lopez was born in Popayan, Colombia, studied medicine in the University of Cauca (1984) under his father’s (José María Delgado) supervision; who was a master in human anatomy. His passion for human anatomy and biomechanics was born from his father’s influence. He makes part of the prestigious Corin Academy of UK; which has allowed his work centre (Sant Celoni) to be recognized as an excellence centre. He is also interested in aseptic loosening in THA and its relationship with THA stability. He is currently researching tribology and the design of a new prosthetic concept for hip replacement.