Original ArticleWhy Make the Cut? Trochanteric Slide Osteotomy Can Improve Exposure to the Anterosuperior AcetabulumPhelps, Kevin D. MDa; Crickard, Colin V. MDb; Li, Katherine MDa; Harmer, Luke S. MD, MPHa; Andrews McArthur, Erica MDa; Sample Robinson, Katherine MDa; Sims, Stephen H. MDa; Hsu, Joseph R. MDaAuthor Information aDepartment of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC; and bCommander, Medical Corps, United States Navy, Naval Medical Center Portsmouth, Portsmouth, VA. Reprints: Joseph R. Hsu, MD, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204 (e-mail: [email protected]). J. R. Hsu reports personal fees from Smith & Nephew (speaker bureau) and Globus Medical (consulting). The remaining authors report no conflict of interest. Journal of Orthopaedic Trauma: February 2021 - Volume 35 - Issue 2 - p 106-109 doi: 10.1097/BOT.0000000000001900 Buy Metrics Abstract Objective: To define relative increases in visual bony surface area and access to critical landmarks with the addition of a trochanteric slide osteotomy to a Kocher–Langenbeck approach. Methods: A Kocher–Langenbeck approach followed by a trochanteric slide osteotomy was sequentially performed on 10, fresh-frozen, hemipelvectomy cadaveric specimens. Visual and palpable access to relevant surgical landmarks was recorded. Calibrated digital photographs were taken of each approach and analyzed using Image J. Results: The acetabular surface area exposed was 27.66 (±6.67) cm2 for a Kocher–Langenbeck approach. This increased to and 41.82 (±7.97) cm2 with the addition of a trochanteric osteotomy. The exposed surface area was increased by 51.2% for the trochanteric osteotomy (P < 0.001). The superior margin of the acetabulum could be visualized and palpably accessed in both exposures. Access to the more anterosuperior portions of the acetabulum was consistently possible in the trochanteric osteotomy but not with the Kocher–Langenbeck approach. Conclusions: A trochanteric osteotomy may visually improve access to the most anterosuperior acetabulum but does not significantly improve surgical access to relevant portions of the superior acetabulum when compared with a Kocher–Langenbeck approach. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.