Hip – Medial

Landmarks for the medial approach with the hip in the frog leg position
Landmarks for the medial approach with the hip in the frog leg position. The incision (3) follows adductor longus, medial to the marked femoral vein, artery and nerve (2). Image from Ramón R, Holguín E, Ribas M, Al Hussin N, Ezechieli M. Modified Ludloff’s medial approach for resection of heterotopic ossification of the hip following severe SARS-CoV-2 infection, a case report. J Hip Preserv Surg. 2024, 11(2), 150-155. CC BY 4.0.
PositionSupine, hip flexed, abducted and externally rotated
Skin3-4 cm incision parallel and 1cm distal to the groin crease
SuperficialAdductor longus is divided close to the pubic tubercle Obturator nerve (anterior branch) is identified and protected
DeepBetween pectineus and adductor brevis Medial Femoral Circumflex Artery is identified and protected Psoas tendon divided at insertion T shaped capsulotomy
DangersObturator nerve – predominantly anterior Femoral neurovascular bundle Medial Femoral Circumflex Artery
AdditionalDivide Transverse acetabular ligament Capsular plication Ligamentum teres tenodesis
Hip - Medial, adductor longus
Adductor longus. Image by Berichard, Wikimedia Commons, CC BY-SA 3.0.

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.