Hyphenated-History: The Kocher-Langenbeck Surgical Approach

Abstract

The language spoken by orthopaedic surgeons is filled with eponyms. In orthopaedics, perhaps more than any other medical specialty, we speak cryptically to one another using code words and other secret language. Certain hyphenated eponyms are of particular interest because they pique one's curiosity as to how these people came to be partners in orthopaedic history. In this paper, we offer some bits of orthopaedic hyphenated-history, outlining the pertinent work of Theodor Kocher and Bernhard von Langenbeck, as well as associated background information. These two surgeons are linked through a common hyphenated eponym in orthopaedic surgery: the Kocher-Langenbeck surgical approach, a well-known posterior approach to the proximal femur and acetabulum.

Which Approach for Total Hip Arthroplasty: Anterolateral or Posterior?

“…Adequate exposure of the acetabulum necessitates neutralizing the abductor mechanism [17] either by performing a trochanteric osteotomy [7,26] or by partial detachment of the anterior portion of the gluteus medius and minimus off the greater trochanter. The posterior approach which was described initially by von Langenbeck and then by Kocher according to Mehlman et al [24], and later by Gibson [11], uses a gluteus maximus split and remains posterior to the gluteus medius and minimus [32]. The posterior hip capsule is divided and the external rotators (piriformis, superior and inferior gemelli, and obturator internus) are detached [23].…”

Theodor E. Kocher (1841-1917): Nobel Surgeon Of The Last Century

“…He succeeded Lücke, as Professor of Surgery in Bern in 1872, and in 1874 published the report of his first 13 goitre operations with only 2 deaths. 1,3 He did a lot of experimental work on the thyroid gland and was the first to excise the thyroid for goitre in 1876.…”

Functional and radiological outcome of acetabular fractures and the factors affecting the outcome

“…Operative treatment is complex due to the complex threedimensional anatomy, limitations of the surgical approaches & extensive dissection of the large muscles about the hip [11][12][13][14] . The relative merit of each surgical option must be considered, and the decision is often a compromise of exposure vs. complications.…”