- See: Total Hip Replacement Menu:
- revision arthroplasty menu
- Femoral Revision:
- exposure of femur:
- it is essential that prior to attempted femoral component removal, that there is a clear retrograde path for stem removal;
- this means that any trochanteric overhang is removed, either with a high speed bur or with an trochanteric osteotomy:
- some recommend routine trochanteric osteotomy;
- removal of femoral component: (trochanteric osteotomy)
- removal of broken femoral stems:
- removal of cementless stems:
- removal of cemented femoral stems:
- femoral windowing:
- indications:
- presence of a large cortical pedestal which lies at the stem tip;
- large cement column;
- varus stem position;
- technique:
- motorized burr is used to make a longitudinal window over the area of difficulty;
- references:
- Controlled perforation: A safe method of cement removal from the femoral canal.
- The window technique for the removal of broken femoral stems in total hip arthroplasty.
- Femoral windows in revision total hip arthroplasty.
- Component removal in revision total hip arthroplasty.
- reaming:
- often long curved femoral stems are required, in which case flexible reamers are needed;
- careful to avoid eccentric reaming;
- reconstruction of femoral bone defects:
- references:
- Revision total hip arthroplasty with osseous allograft reconstruction. A clinical and roentgenographic analysis.
- Freeze-dried proximal femur allografts in revision total hip arthroplasty. A preliminary report.
- Iontophoresed segmental allografts in revision arthroplasty for infection.
- Preparation of the proximal femur in cementless total hip revision.
- femoral component insertion:
- cementless femoral revision:
- cemented femoral revision:
- complications:
- femur fracture
- references:
- Intraoperative Complications of Revision Hip Arthroplasty Using a Porous-Coated, Distally Slotted, Fluted Femoral Stem.
- Femoral Artery and Vein Injury After Cerclage Wiring of the Femur: A Case Report.
Revision total hip arthroplasty
Long-term results of revision total hip replacement. A follow-up report.
Multiple revisions for failed total hip arthroplasty not associated with infection.
Preparation of the proximal femur in cementless total hip revision.
Revision surgery for failed, nonseptic total hip arthroplasty: the femoral side.