DESCRIPTION:
Revision total hip arthroplasty (THA) helps solve the reconstructive challenges facing surgeons today. This comprehensive text encompasses the necessary background and foundation for the reader to better understand the principles of revision THA, highlighting the preferred techniques and solutions of regional centers across the US that are known for excellence in revision THA.
Across eleven thematic sections, this book presents modern techniques to solve common problems, with an emphasis on intra-operative and clinical photos. The opening section discusses general considerations and principles of revision THA, including the global burden, soft tissue balancing and biomechanics, and biomaterials. The next few sections cover evaluation, pre-operative planning and surgical exposures, then dive into acetabular, femoral and trochanteric reconstruction techniques. An entire section is dedicated to author-preferred techniques for managing instability, aseptic loosening, periprosthetic infection and fracture, corrosion, implant failure and more. The final sections discuss methods to minimize complications, unique considerations and special considerations for revision THA, from abductor tears to the role of physical therapy.
This well-illustrated, state-of-the-art-text will prepare orthopedic surgeons of every level to solve unique and common etiologies of failed THA, making this a practical guide for every revision surgeon.
CONTENTS:
Generalized Principles in Revision THA
Revision Burden: Projections in the United States and Worldwide
Soft Tissue and Biomechanics
Reconstruction of Femoral Defects: ETO, Tapered Modular Stem, and Mega-Prosthesis
Reconstruction of Acetabular Defects (i.e., Augments, Bone Grafts, Cups, and Cages)
Considerations of Biomaterials in Revision Total Hip Arthroplasty
Basic Science of Total Hip Arthroplasty Failure
Evaluation of the Painful Total Hip Arthroplasty (PTHA)
Approach to the Evaluation of the Painful Total Hip Arthroplasty
Radiographic Evaluation of Failed Total Hip Arthroplasty
Hip-Spine Evaluation
Special Medical Considerations When Evaluating the Painful Total Hip Arthroplasty
Preoperative Planning
Acetabular Evaluation and Classification of Failure
Preoperative Femoral Evaluation and Classification of Failure
The Patient Evaluation and Optimization of Modifiable Risk Factors Before Revision THA
Revision Hip Arthroplasty: Blood, Fluid, and Anesthesia
Bone Graft and Bone Substitutes
Implant Inventory
Surgical Approaches/exposure
Posterolateral Approach
Extended Trochanteric Osteotomy
Direct Anterior Approach (DAA)
The Direct Anterior Revision Total Hip Arthroplasty
Extended Trochanteric Osteotomy (ETO) and Anterior Cortical Window (ACW) Through an Extensile Direct Anterior Approach (DAA)
Direct Lateral
Trochanteric Slide Osteotomy
Anterior-Based Muscle Sparing (ABMS) Approach
Removal and Reinsertion of Femoral Components in Revision Total Hip Arthroplasty
Removal of Well-Fixed Acetabular Components
Removal of Well-Fixed Femoral Stems
Acetabular Reconstruction Techniques
Landmarks to Determine Anatomic Hip Center of Rotation
Use of the Hemispherical Cup for Revision Total Hip Arthroplasty
Augments
Acetabular Buttress
Cup-Cage Constructs
Cage
Custom Triflange
Pelvic Discontinuity Techniques
Structural Allografts
Femoral Reconstruction Techniques
Tapered Modular Stems
Proximal Porous Modular Stems
Nonmodular Stems (Wedge- or HA-Coated)
Fully Porous Stems
Calcar Replacing Stems in Revision Total Hip Arthroplasty
Articulating Antibiotic Cement Spacers
Non-articulated Antibiotic Cement Spacer/Resection Arthroplasty
Proximal Femur Replacement
Total Femoral Replacement
Cemented Stems
Impaction Grafting
APC
Trochanteric Reconstruction Techniques
Wires, Cables, Sutures, and Plates
Surgical Techniques in Revision Total Hip Arthroplasty-Authors Preferred Techniques
Instability
Aseptic Loosening
Infection
Periprosthetic Fracture
Revision Total Hip Arthroplasty in the Setting of Trunnionosis
Broken Femoral Stems
Osteolysis
Use of Megaprosthesis Total Femur Replacement
Use of Cages and Custom Triflanges
Minimizing Complications After Revision THA
Neurological Injury
Evaluation and Treatment of Thigh Pain Following Total Hip Arthroplasty
Vascular Injury
Postoperative Infection
Minimizing Instability After Revision Total Hip Arthroplasty
Venous Thromboembolic Prophylaxis in Revision Hip Arthroplasty
Revision Total Hip Arthroplasty: Postoperative Wound Complications
Revision THA-Unique Surgical Considerations
Complex THA After Previous Surgeries
Complex THA After Acetabular Fracture
Extra-Articular Muscle and Tendon Pathology: Lateral Trochanteric Pain, Abductor Deficiency, and Iliopsoas Impingement
Heterotopic Ossification
Combined Abdominal and Pelvic Approaches
Revision THA for LLD
Conversion of Girdlestone Resection Arthroplasty to Total Hip Arthroplasty
Takedown Arthrodesis Conversion to Total Hip Arthroplasty
Metastatic Disease of the Hip
Special Considerations with Revision THA
Revision Total Hip Arthroplasty in the Ambulatory Surgery Centers
Using Current Data and Research to Drive Decision-Making
Evaluating Outcomes in Revision THA
Considering Malpractice in Revision Total Hip Arthroplasty
The Role of Physical Therapy in Revision Total Hip Arthroplasty
Maximizing Efficiency in Revision Total Hip Arthroplasty
Financial Implications of Revision Total Hip Arthroplasty
