A modification of the posterior approach in total hip replacement, S.P.A.I.R.E. has the benefit of avoiding cutting the abductor complex as well as preserving both gemelli, obturator internus and piriformis tendons (quadriceps coxae).
During his fellowship training in the world-renowned Exeter Hip Unit, Prof. Lee has perfected the S.P.A.I.R.E technique under the mentorship of Professor Timperley.
After reviewing the results and publishing the advantages of this technique in medical journals, S.P.A.I.R.E. has become Prof. Lee’s routine practice for total hip replacement.
No Restriction is required following S.P.A.I.R.E. Hip Replacement, the muscles at the back of the hips are preserved with this approach. They act as checkreins to reduce the risk of dislocation after surgery.
This technique has been described as S.P.A.I.R.E. (Sparing Piriformis And Internus, Repair Externus), which will offer the functional benefits of the posterior approach to facilitate early mobilisation with reduced risk of dislocation (Hanly et al 2017)
Research has shown that the quadriceps coxae is not just an external rotator and is the primary abductor and extensor for the hip joint in a 90° flexed position,
which means it has a major effect on one-legged and weight-bearing rising and propulsive motions.
These muscles are essential every time a patient tries to get up from a chair (Lee et al 2012).
The SPAIRE Technique Allows Sparing of the Piriformis and Obturator Internus in a Modified Posterior Approach to the Hip
Details of a Tendon–Sparing Posterior Approach in Hemiarthroplasty in the Treatment of Displaced Intracapsular Neck of Femur Fracture
Paul YF Lee, John Charity. and John Timperley
EARLY FUNCTIONAL EFFECT OF THE SPAIRE® TECHNIQUE ON FUNCTIONAL OUTCOMES AND GAIT ANALYSIS
RJ Hanly, E Swanton, A Woodbridge, M Mohaddes, SL Whitehouse, AJ Timperley