Corail Pinnacle (De Puy)Total Hip replacement ( Midi-posterior approach)


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Learn the Corail Pinnacle (De Puy)Total Hip replacement ( Midi-posterior approach) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Corail Pinnacle (De Puy)Total Hip replacement ( Midi-posterior approach) surgical procedure.

The posterior approach has taken over from the anterolateral approach as the workhorse of primary total hip replacement and revision hip exposures.

Traditionally the anterolateral approach has enjoyed widespread popularity, but the realisation that abductor damage and superior gluteal nerve injury could ensue has resulted in a move towards function sparing posterior approaches. Historically, the posterior approach has been associated with higher dislocation rates but attention to capsular preservation and external rotator closure has reduced this complication to acceptable levels.

Traditional Southern approach incisions span from the piriformis tendon proximally  to the gluteus maximus insertion distally.  This approach gives an excellent exposure and is useful in most revision scenarios; it is however more extensive than is really required routinely to position conventional components correctly. I have never been an advocate of minimal access surgery on the basis that choice, alignment and longevity of implant is paramount. I do however acknowledge that smaller incisions correctly performed generally result in a faster and more comfortable recovery for the patient.As a compromise, I have reduced the size of my routine posterior approach incision basing it more accurately on the posterior border of the greater trochanter, the deeper incision excluding piriformis and gluteus maximus tendon; I call this the ‘midiposterior’ approach which is described hereafter.




Author: Ronan Treacy FRCS (Tr & Orth).

Institution: The Royal Orthopaedic Hospital, Birmingham, UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


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