Short 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.

Long 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.

Table of Contents:

Part I. Generalized Principles in Revision THA.- Revision burden-projections in US and world-wide.- Soft tissue balancing/biomechanics.- Reconstruction of femoral defects- ETO, tapered modular stem, mega prosthesis.- Reconstruction of Acetabular defects- augments, bone graft, cup, cages.- Consideration of biomaterials (ceramics, corrosion, cement).- Basic science of THA failure.- Part II. Evaluation of the Painful Total Hip Arthroplasty (PTHA).- History and Physical, laboratory, injections.- Radiographic evaluation of the PTHA.- Hip-spine evaluation.- Special medical considerations (RSD, MS, cervical stenosis, Neurological).- Part III. Preoperative Planning.- Acetabular evaluation and classification of failure.- Femoral evaluation and classification of failure.- The patient evaluation and optimization of modifiable risk factors before revision THA.- Blood/fluid and Anesthesia.- Bone graft and bone substitutes.- Implant inventory-general (stem choices, acetabular choices) and Specialized Equipment -long chapter.- Part IV. Surgical Approaches/exposure.- Posterolateral.- Extended Trochanteric Osteotomy.- Direct anterior.- Direct anterior (Naylor).- Anterior based osteotomies.- Direct lateral.- Trochanteric slide osteotomy.- Anterolateral.- Tap out-tap in technique.- Removal of Well-fixed acetabular components.- Removal of well-fixed femoral components.- Part V. Acetabular reconstruction techniques.- Landmarks to determine anatomic hip center of rotation.- Hemispherical cup.- Augments.- Buttress.- Cup/cage.- Cage.- Custom triflange.- Pelvic discontinuity techniques.- Structural allografts.- Part VI. Femoral Reconstruction techniques.- Tapered modular stems.- Proximal porous modular stems.- Non-modular stems (Wedge or HA coated).- Fully porous stems.- Calcar replacement stems.- Articulated Antibiotic cement spacer.- Non-articulated antibiotic cement spacer/resection arthroplasty.- Proximal femoral replacement.- Total femoral replacement.- Cemented stems.- Impaction grafting.- APC.- Part VII. Trochanteric reconstruction techniques.- Short Plate, Long plate, Wires/sutures.- Part VIII. Surgical Techniques in Revision Total Hip Arthroplasty: Authors preferred techniques.- Instability.- Aseptic Loosening.- Infection.- Periprosthetic fracture.- Corrosion.- Implant Failure/Implant Fracture.- Osteolysis.- Use of Mega-prosthesis/total femur.- Use of Cages and custom triflanges.- Part IX. Minimizing complications after Revision THA.- Neurological Injury.- Thigh pain.- Vascular injury.- Postoperative Infection.- Instability.- VTE.- Wound Complications.- Part X. Revision THA: Unique surgical considerations.- Complex THA after previous surgeries.- Complex THA after Acetabular fracture.- Abductor tears, soft-tissue impingement, iliopsoas, rectus.- HO.- Combined abdominal and pelvic approaches.- Revision THA for LLD.- Conversion of Girdlestone arthroplasty to THA.- Conversion of hip arthrodesis to THA.- Metastatic Disease of the Hip.- Part XI. Special considerations with Revision THA.- Performing revision THA in ASC?s.- Using current data and research to drive decision-making.- Evaluating Outcomes in Revision THA.- Considering malpractice in revision THA.- The role of physical therapy in revision THA.- Maximizing efficiency in revision THA (hospital and personnel).- Financial implications of revision THA (surgeon and hospital).